Effect of vitamin D supplementation on procalcitonin as prognostic biomarker in patients with ventilator associated pneumonia complicated with vitamin D deficiency

Document Type: Research article

Authors

1 Clinical Pharmacy Department, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Department of Infectious Diseases, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Department of Critical Care, Shohadaye-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Loghman Clinical Research Development Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Ventilator-associated pneumonia (VAP) is a common and serious problem that develops after more than 48 hours of mechanical ventilation. Improving the activity of immune system with vitamin D, and its consequent impact on prognostic biomarkers of VAP was studied in the current study.
A randomized double blind placebo controlled clinical trial was designed. A total of 46 patients with VAP, who were suffering from vitamin D deficiency, were randomly allocated into the study groups of placebo (n=22) and treatment (n=24). The treatment group received 300,000 units of intramuscular vitamin D. Serum levels of procalcitonin and vitamin D along with SOFA and CPIS scores were determined at baseline and on day 7 after intervention. The mortality rate of patients was also monitored for the succeeding 28 days after the injection.
The administration of vitamin D significantly enhanced its levels (P<0.0001) in the treated patients (12.28 ± 8.26) in comparison to placebo group (1.15 ± 1.50). The levels of PCT were significantly decreased (p=0.001) in the treatment group (– 0.02 ± 0.59 ng/ml) compared to that of placebo group (0.68 ± 1.03 ng/ml). However, changes in SOFA and CPIS scores were not significantly different between study groups (p=0.63 and p=0.32, respectively). Interestingly, the mortality rate of patients in the treatment group (5/24) was significantly lower (p=0.04) than that of the placebo group (11/22).
In conclusion, our results indicate that vitamin D supplementation can significantly reduce the procalcitonin in VAP patients, and must be considered a preventive and/or therapeutic strategy.

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