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Ushama Pj: Vitamin K – From ICU Emergencies to Long-Term Health
Ushama Pj/LinkedIn
Apr 29, 2026, 01:48

Ushama Pj: Vitamin K – From ICU Emergencies to Long-Term Health

Ushama Pj, Intensive Care Nurse and Former Cardiac Icu Nursing Supervisor at Alemeis hospital Saudi Arabia, shared a post on LinkedIn:

“What is Vitamin K?

Vitamin K is a fat-soluble vitamin that exists in two main forms:

  • K1 (Phylloquinone) – Found in green leafy vegetables
  • K2 (Menaquinone) – Produced by gut bacteria and found in fermented foods

Core Mechanism – Why Vitamin K is Essential

Vitamin K is required for the activation of clotting factors through a process called:

\gamma\text(-carboxylation of glutamate residues in clotting factors II, VII, IX, X)

This modification allows clotting factors to bind calcium and function effectively in the coagulation cascade.

Role in Coagulation

Vitamin K is essential for synthesizing:

  • Factor II (Prothrombin)
  • Factor VII
  • Factor IX
  • Factor X

Without Vitamin K, patients are at risk of:

  • Prolonged PT/INR
  • Spontaneous bleeding
  • Life-threatening hemorrhage

Bone Health and Metabolism

Vitamin K activates osteocalcin, a protein responsible for binding calcium to bone.

Clinical relevance:

  • Supports bone mineralization
  • May reduce fracture risk
  • Works synergistically with Vitamin D

Cardiovascular Impact

Vitamin K helps regulate calcium deposition by activating Matrix Gla Protein (MGP):

  • Prevents vascular calcification
  • Supports arterial flexibility

Emerging evidence links low Vitamin K levels with increased cardiovascular risk.

Deficiency – Who is at Risk?

Vitamin K deficiency can occur in:

  • Newborns (low stores + sterile gut)
  • Patients on long-term antibiotics
  • Liver disease patients
  • Fat malabsorption syndromes

Clinical signs:

  • Easy bruising
  • Bleeding gums
  • GI bleeding
  • Increased PT/INR

Critical Care Insight

In ICU and cardiac settings:

  • Vitamin K is used to reverse Warfarin effects
  • Essential in managing coagulopathy
  • Routinely given to newborns to prevent Vitamin K Deficiency Bleeding (VKDB)

Dietary Sources

  • Spinach, kale, broccoli
  • Liver and egg yolk
  • Fermented foods (rich in K2)

Supplementation – Be Careful

Excess Vitamin K is rare, but:

  • Can interfere with anticoagulant therapy
  • Requires careful monitoring of INR in cardiac patients

Clinical Takeaway

Vitamin K is not just about clotting — it is a multifunctional vitamin influencing coagulation, bone strength, and vascular health.

In critical care, understanding its role can be life-saving, especially in bleeding disorders and anticoagulant management.

From ICU emergencies to long-term health — Vitamin K plays a crucial, often underestimated role.”

Ushama Pj

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