{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:23:50Z","timestamp":1753889030657,"version":"3.40.5"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite multiple studies suggesting that low 25(OH)D\u2010vitamin levels are associated with worse outcomes in critically ill individuals, attempts to mitigate the outcomes by fixed dose enteral supplementation unguided by baseline or target blood levels have been unsuccessful. Since a single measurement of 25(OH)D may not optimally reflect an individual's vitamin D status, we studied the plasma concentration of different vitamin D metabolites and their recovery during and following resolution of acute critical illness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective observational study including patients 18\u2009years and older admitted to a mixed medical\u2010surgical ICU in Reykjavik, Iceland, located at a high\u2010northern altitude (64\u00b0\u2009N). Vitamin D metabolites were measured at three timepoints; On admission (S1), 3\u20135\u2009days following admission (S2) and after recovery from acute illness (median 178\u2009days) (S3). Concentrations of total 25(OH)D\u2010vitamin, cholecalciferol (D<jats:sub>3<\/jats:sub>), total 24,25(OH)D\u2010vitamin, vitamin D binding protein (VDBP) were measured with LC\u2010tandem mass spectrometry (LC\u2013MS\/MS) and free 25\u2010(OH)D was measured with enzyme\u2010linked immunosorbent assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most individuals were vitamin D deficient when assessed during critical illness, with 25(OH)D\u2010vitamin levels under 30\u2009ng\/ml for 37\/40 individuals at timepoint S1 and 34\/38 at S2. After recovery, 18\/30 patients were deficient at S3. Levels of all vitamin D metabolites measured were low during critical illness but rose substantially following resolution of acute illness. No strong correlation was found between markers of acute illness severity or duration and resolution of vitamin D metabolites in the interval between acute illness and recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In critically ill patients, levels of multiple vitamin D metabolites are low but substantial recovery occurs following resolution of acute illness. It is unclear whether a single metabolite is sufficient to assess vitamin D status of critically ill patients and guide potential supplementation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14137","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T05:24:05Z","timestamp":1660886645000},"page":"1202-1210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in vitamin D metabolites at the time of critical illness and 6\u2009months later\u2014A prospective observational study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-2810","authenticated-orcid":false,"given":"Gudrun Maria","family":"Jonsdottir","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine, Operational Services Landspitali \u2010 The National University Hospital of Iceland  Reykjavik Iceland"},{"name":"Department of Anesthesiology 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