Evaluating the Impact of Vitamin D Supplementation on Healing Bed Sores in ICU.

inclusion criteria:

* Critically ill patients with bed sores Grade (1-2), (non-light) exudate admitted to ICUs.
* Serum vitamin D \<20 ng/mL.
* Both genders.
* Age: 18-60 years.
* enteral access in place to enable delivery of vitamin D3 and are deemed to be able to tolerate enteral drug administration.
* GCS \> 9.
* Serum Calcium (8-10 mg/dl).
* Serum creatinine less than 1.4 mg/dL.

exclusion criteria:

* Refusal of the legal guardian of the patient to participate in the study.
* Current pregnancy or lactating mother.
* Patients who are terminally ill and expected to die in less than 72 hours.
* Renal dysfunction (GFR \< 30 mL/min) and the onset of dialysis during the study.
* Vitamin D supplementation in the last 15 days.
* Hypo/hyper-calcemia (adjusted calcium less than 8 mg/dL or above 10).
* History of disorders associated with hypercalcemia (history of cancer with history of hypercalcemia within the past 1 year, hyperparathyroidism, sarcoidosis, nephrolithiasis).
* History of parathyroid dysfunction.
* Ongoing shock, \[defined as unstable blood pressure despite vasopressor support and mean arterial pressure (MAP) \< 60 mm Hg on at least 3 consecutive readings within a 3-hour period prior to study entry\].
* History of malabsorption syndromes; gastrointestinal intolerance (diarrhea, vomiting, or increased nasogastric aspirates).
* History of adverse reaction to vitamin D supplementation.
* known history of cirrhosis.
* Patients taking any medications that have serious drug interactions with vitamin D like statins, orlistat, aluminum hydroxide (interfere with the absorption of vitamin D), digoxin (can enhance the effects of vitamin D on the heart leading to potential toxicity), and certain diuretics (can cause high calcium levels).