{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:17:01Z","timestamp":1760059021947,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Scientific Fund of the Mayor of the City of Vienna","award":["19040"],"award-info":[{"award-number":["19040"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Therapeutic interventions, such as extracorporeal membrane oxygenation (ECMO) therapy, in patients suffering from severe acute respiratory distress syndrome (ARDS) may reduce their vitamin D levels. Many observational studies have shown associations between poor outcomes and low vitamin D levels in critically ill patients. This retrospective study primarily aimed to investigate the time-dependent changes in vitamin D levels and the correlation of vitamin D levels with disease severity and inflammatory markers in patients suffering from ARDS receiving ECMO therapy. Materials and Methods: This study used a longitudinal approach to assess the serial changes and the correlations of vitamin D levels (25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D)) with disease severity and inflammatory markers in 24 invasively mechanically ventilated (IMV) patients treated using ECMO over a period of 17 days. Most of the patients in this study were suffering from severe coronavirus disease 2019 (COVID-19) (n = 19; 79%). Serial blood samples collected during routine blood draws were retrospectively analyzed to assess the dynamics of their vitamin D levels over 17 days of ICU therapy. Results: Hypovitaminosis D (25(OH)D \u2264 50 nmol\/L) was prevalent in 18 (75%) patients, while values of 25(OH)D lower than 30 nmol\/L were measured in 5 patients (21%), indicating severe deficiency. Additionally, 1,25(OH)2D showed a significant decrease within the first 11 days of intensive care unit (ICU) treatment (these levels dropped by 28%; p = 0.03) and then remained at similar levels throughout the observational period; 25(OH)D levels remained largely unchanged during the observation period. We observed that 25(OH)D showed a significant negative correlation with C-reactive protein (CRP) (p = 0.04), and that 25(OH)D and 1,25(OH)2D levels did not show correlations with disease severity. Conclusions: Patients suffering from severe COVID-19 ARDS showed a significant decrease in their 1,25(OH)2D levels from day 0 to day 11 in the ICU. Therefore, routine vitamin D substitution and monitoring in critically ill patients, especially for patients suffering from ARDS treated with ECMO, should be carried out to prevent hypovitaminosis D. In addition, vitamin D may be associated with inflammation. Further studies are necessary to elucidate the mechanisms behind these retrospective observations.<\/jats:p>","DOI":"10.3390\/medicina61050901","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T06:57:28Z","timestamp":1747378648000},"page":"901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serial Changes in Vitamin D Status in Patients During Severe Acute Respiratory Distress Syndrome and Extracorporeal Membrane Oxygenation"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4669-2482","authenticated-orcid":false,"given":"Martina","family":"Hermann","sequence":"first","affiliation":[{"name":"Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7972-1677","authenticated-orcid":false,"given":"Jelena","family":"Poslussny","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gernot","family":"Gerger","sequence":"additional","affiliation":[{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helmuth","family":"Haslacher","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Laboratory Medicine, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Mayrhofer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, 1090 Vienna, Austria"},{"name":"Medical University of Vienna, Department of Environmental Health, Center for Public Health, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5910-3053","authenticated-orcid":false,"given":"Verena Eva","family":"Tretter","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-0742","authenticated-orcid":false,"given":"Mathias","family":"Maleczek","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anaesthesia and Intensive Care Medicine, 1090 Vienna, Austria"},{"name":"Ludwig Boltzmann Institute for Digital Health and Patient Safety, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cem","family":"Ekmekcioglu","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Environmental Health, Center for Public Health, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/MAT.0000000000001630","article-title":"ELSO Guidelines for Adult and Pediatric Extracorporeal Membrane Oxygenation Circuits","volume":"68","author":"Gajkowski","year":"2022","journal-title":"ASAIO J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1343","DOI":"10.1210\/clinem\/dgaa733","article-title":"Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection","volume":"106","author":"Hernandez","year":"2021","journal-title":"J. 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