Investigation into a potential role for vitamin D in the pathogenesis of acute respiratory distress syndrome

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Dancer, Rachel Catherine Anne (2017). Investigation into a potential role for vitamin D in the pathogenesis of acute respiratory distress syndrome. University of Birmingham. Ph.D.

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Abstract

Patients undergoing oesophagectomy are at risk of developing Acute Respiratory Distress Syndrome (ARDS), an immune mediated form of severe respiratory failure. The immunomodulatory properties of Vitamin D are increasingly recognised. We hypothesised that preoperative Vitamin D supplementation would reduce levels of perioperative alveolar oedema in patients undergoing oesophagectomy.

Vitamin D deficiency is common in patients with and at risk of ARDS. High dose supplementation with cholecalciferol is a safe and effective method of increasing Vitamin D levels. Supplementation reduces perioperative increases in inflammatory alveolar oedema.

Circulating levels of the active form of Vitamin D relate to long term post-operative mortality. Patients who survive at least 2 years post-op have higher preoperative circulating numbers of Natural Killer cells. We did not find any evidence of an effect of Vitamin D on Natural Killer Cells.

In conclusion, preoperative Vitamin D status relates to perioperative changes in inflammatory alveolar oedema and high dose Vitamin D supplementation is a safe and effective method of improving preoperative Vitamin D status. Preoperative cholecalciferol administration should be considered in patients with and at risk of vitamin D deficiency.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

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