ChoLecalciferol and ErgocAliferol Replacement iN CriTically InjurEd BuRN Patients: An Observational Cohort Study (LANTERN).

Vitamin D deficiency appears to be more prevalent than previously considered in the adult critically ill population, and specifically burn-injured patients. No definitive regimen has been shown to restore vitamin D (25(OH)D) levels more effectively to therapeutic levels in the burn-injured population. The purpose of this study was to investigate the effects of either ergocalciferol (D2, 50,000 IU weekly) or cholecalciferol (D3, 6,000 IU daily) in adults with burns ≥ 10% TBSA. This retrospective, observational study (2020-2022) included patients with vitamin D deficiency (< 30 ng/mL) who received replacement and had monitoring with weekly vitamin D levels. Patients on dialysis or those with a hospital length of stay (LOS) less than 2 weeks were excluded. Forty-five patients treated with ergocalciferol and 99 patients with cholecalciferol were included in the study. Patients treated with cholecalciferol were more likely to achieve 25(OH)D levels greater than 30 ng/ml compared to ergocalciferol over a 42-day period (HR 23.56, [95% CI, 12.57-44.16, p<0.0001). A higher proportion of patients in the cholecalciferol group achieved vitamin D greater than 20 ng/ml (HR 6.37, [95% CI, 4.20-9.66, p<0.0001). The adjusted hazard ratios (D3 vs D2) for achieving 25(OH)D levels > 30 ng/ml and > 20 ng/ml were and 23.94 (95% CI 5.09-427.6, p=0.0019) and 7.32 (95% CI 3.83-15.52, p<0.0001) respectively, after controlling for TBSA and initial 25(OH)D. Cholecalciferol appears to be a more effective agent than ergocalciferol for correcting vitamin D deficiency and insufficiency in patients with burn injuries.
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