Specific Considerations Relevant to Critical Illness

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Book Contribution

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Only recently it has been recognized that vitamin D, which in reality is a steroid prohormone, may be of great interest to various aspects of critical illness not only because of its classic function in the regulation of calcium homeostasis but of its suspected pleiotropic effects. Since 2011, several observational studies have demonstrated a strong association between vitamin D deficiency and adverse outcomes, specifically higher mortality in this vulnerable population. The major current vitamin D and nutrition guidelines do not specifically address vitamin D requirements of critically ill patients, and typical nutrition formulas and supplements contain only modest amounts that are likely insufficient to correct vitamin D deficiency or unable to cover even daily requirements of severely ill individuals. In this chapter, the current knowledge on vitamin D is summarized and an overview on data that are specifically relevant to a number of disease states in critically ill patients is given. Readers are also referred to the general aspects of vitamin D as it pertains to acute illness in the chapter by Dr Youssef et al.