CC BY-NC-ND 4.0 · Journal of Cardiac Critical Care TSS 2022; 06(03): 195-200
DOI: 10.1055/s-0042-1759822
Systematic Review

Effect of Vitamin D Supplementation on Postoperative Outcomes in Cardiac Surgery Patients: A Systematic Review

Sambhunath Das
1   Department of Cardiac Anaesthesia and Critical Care, AIIMS, New Delhi, India
Punyatoya Bej
2   Department of Community Medicine, Rama Medical College and Research Centre, Hapur, Uttar Pradesh, India
› Author Affiliations
Funding None.


Background Vitamin D deficiency is a very common occurrence in cardiac patients. It has been proved that cardiac surgery and cardiopulmonary bypass accelerate the deficiency further. The postoperative outcomes of patients deteriorate in the presence of vitamin D deficiency. Perioperative supplementation of vitamin D is the only solution to the problem. Hence, the present systematic review was conducted to derive the efficacy and safety of vitamin D supplementation on postoperative outcomes in cardiac surgery patients.

Method Publications over duration of last 10 years was searched from different database and web sites. The data from full-text research articles were analyzed for the effect on different postoperative outcomes and side effects.

Result Eight randomized control trials were retrieved on the effect of perioperative vitamin D supplementation in cardiac surgery patients and their postoperative outcomes. Six articles (75%) were found to be in favor of improvement in postoperative outcome. Two articles (25%) did not find any difference of outcome between the control and treatment group. All the studies observed the restoration of vitamin D to normal and no adverse effects from supplementation.

Conclusion Perioperative vitamin D supplementation improves the postoperative outcomes after cardiac surgery. It is effective and safe to supplement vitamin D in cardiac surgery patients.

Publication History

Article published online:
03 December 2022

© 2022. Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Holick MF. The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 2017; 18 (02) 153-165
  • 2 Lee JH, O'Keefe JH, Bell D, Hensrud DD, Holick MF. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor?. J Am Coll Cardiol 2008; 52 (24) 1949-1956
  • 3 Abou-Zahr R, Kandil SB. A pediatric critical care perspective on vitamin D. Pediatr Res 2015; 77 (1-2): 164-167
  • 4 Witte KK, Byrom R, Gierula J. et al. Effects of vitamin D on cardiac function in patients with chronic HF: the VINDICATE study. J Am Coll Cardiol 2016; 67 (22) 2593-2603
  • 5 Venkatram S, Chilimuri S, Adrish M, Salako A, Patel M, Diaz-Fuentes G. Vitamin D deficiency is associated with mortality in the medical intensive care unit. Crit Care 2011; 15 (06) R292
  • 6 Ohlrogge AH, Brederecke J, Ojeda FM. et al. The relationship between Vitamin D and postoperative atrial fibrillation: a prospective cohort study. Front Nutr 2022; 9: 851005
  • 7 Barker T, May HT, Doty JR. et al. Vitamin D supplementation protects against reductions in plasma 25-hydroxyvitamin D induced by open-heart surgery: assess-d trial. Physiol Rep 2021; 9 (03) e14747
  • 8 Sahu MK, Bipin U, Niraghatam HV. et al. Vitamin D deficiency and its response to supplementation as “stoss therapy” in children with cyanotic congenital heart disease undergoing open heart surgery. J Cardiac Crit Care 2019; 3 (01) 17-23
  • 9 Talasaz AH, Salehiomran A, Heidary Z. et al. The effects of vitamin D supplementation on postoperative atrial fibrillation after coronary artery bypass grafting in patients with vitamin D deficiency. J Card Surg 2022; 37 (07) 2219-2224
  • 10 Kara H, Yasim A. Effects of high-dose vitamin D supplementation on the occurrence of post-operative atrial fibrillation after coronary artery bypass grafting: randomized controlled trial. Gen Thorac Cardiovasc Surg 2020; 68 (05) 477-484
  • 11 Jelveh-Moghaddam H, Fani K, Hekmat M, Azari A. The effects of vitamin D3 in pediatric patients undergoing congenital heart surgery. J Cell Mol Anesth [Internet] 2020; 5 (02) 67-3
  • 12 Eslami P, Hekmat M, Beheshti M. et al. A Randomized, double-blind, placebo-controlled, clinical trial of high-dose, short-term vitamin D administration in the prevention of acute kidney injury after cardiac surgery. Cardiorenal Med 2021; 11 (01) 52-58
  • 13 Verstuyf A, Carmeliet G, Bouillon R, Mathieu C. Vitamin D: a pleiotropic hormone. Kidney Int 2010; 78 (02) 140-145
  • 14 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357 (03) 266-281
  • 15 Ney J, Amrein K, Heyland DK. et al. Abstract 19707; clinical significance of vitamin D Levels in cardiac surgery. Circulation 2017; 136: A19707
  • 16 Mozos I, Marginean O. Links between vitamin D deficiency and cardiovascular diseases. BioMed Res Int 2015; 2015: 109275
  • 17 McNally JD, Menon K, Chakraborty P. et al. Impact of anesthesia and surgery for congenital heart disease on the vitamin d status of infants and children: a prospective longitudinal study. Anesthesiology 2013; 119 (01) 71-80
  • 18 TekeliKunt A, Tümer NB, Özışık K, Günaydın S. Preoperative vitamin D level predicts operative mortality after cardiac surgery. Eur J Cardiovasc Med 2020; 8: 146-151
  • 19 Cerit L, Özcem B, Cerit Z, Duygu H. Preventive effect of preoperative vitamin D supplementation on postoperative atrial fibrillation. Rev Bras Cir Cardiovasc 2018; 33 (04) 347-352
  • 20 Dohain AM, Almogati J, Al-Radi OO. et al. Serum vitamin D status following pediatric cardiac surgery and association with clinical outcome. Eur J Pediatr 2020; 179 (04) 635-643
  • 21 Javorski MJ, Kerolos MM, Fareed J, Perez-Tamayo RA. Vitamin D and postoperative vasopressor use in cardiopulmonary bypass. Clin Appl Thromb Hemost 2018; 24 (08) 1322-1326
  • 22 Zittermann A, Kuhn J, Ernst JB. et al. 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and postoperative outcome in cardiac surgery. J Clin Endocrinol Metab 2015; 100 (01) 72-80
  • 23 Ney J, Heyland DK, Amrein K. et al. The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients: the eVIDenCe study. Clin Nutr 2019; 38 (06) 2756-2762
  • 24 Turan A, Artis AS, Hanline C. et al. Preoperative vitamin D concentration and cardiac, renal, and infectious morbidity after noncardiac surgery. Anesthesiology 2020; 132 (01) 121-130
  • 25 McNally JD, O'Hearn K, Fergusson DA. et al; Canadian Critical Care Trials Group. Prevention of post-cardiac surgery vitamin D deficiency in children with congenital heart disease: a pilot feasibility dose evaluation randomized controlled trial. Pilot Feasibility Stud 2020; 6: 159