Enteral vitamin D treatment flops for cognitive protection of critically ill patients

Critically ill patients with vitamin D deficiency does not appear to benefit from enteral treatment with high-dose vitamin D3 in terms of global cognition or executive function, as shown in a study.

The study randomized 95 vitamin-D deficient, critically ill patients to receive a single high-dose (540,000 IU) enteral treatment of vitamin D3 (n=47) or placebo (n=48) shortly after hospital admission. Efficacy outcomes were global cognition (measured using the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]) and executive function (assessed using a composite score derived from three Delis–Kaplan Executive Function System subscales).

Assessments were conducted at a median of 443 (interquartile range, 390–482) days after randomization and compared using multivariable proportional odds regression.

Results showed that enteral vitamin D3 treatment produced a significant improvement in neither global cognition nor executive function. The adjusted median RBANS score at follow-up was 79.6 (95 percent confidence interval [CI], 73.0–84.0) in the vitamin D3 group versus 82.1 (95 percent CI, 74.7–84.6) in the placebo group (adjusted odds ratio [aOR], 0.83, 95 percent CI, 0.50–1.38).

Likewise, the adjusted median executive function composite score was similar in the treatment groups (8.1, 95 percent CI, 6.8–9.0 vs 8.7, 95 percent CI, 7.4–9.3, respectively), with an aOR of 0.72 (95 percent CI, 0.36–1.42).