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Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care
Author(s) -
Onwuneme Chike,
Carroll Aoife,
Doherty Dermot,
Bruell Heike,
Segurado Ricardo,
Kilbane Mark,
Murphy Nuala,
McKenna Malachi J.,
Molloy Eleanor J.
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13090
Subject(s) - medicine , sepsis , vitamin d and neurology , pediatric intensive care unit , vitamin d deficiency , confounding , pediatrics , prospective cohort study , intensive care unit , intensive care , intensive care medicine
Aim This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit ( PICU ). We also investigated the association between vitamin D status and clinical outcomes. Methods Serum 25‐hydroxy vitamin D (25 OHD ) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU . The relationship between 25 OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age. Results We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25 OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25 OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25 OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25 OHD and C‐reactive protein ( CRP ): each 0.1% decrease in 25 OHD increased CRP (p = 0.04). Conclusion Children admitted to the PICU with suspected sepsis had lower 25 OHD than controls and inadequate 25 OHD status was associated with confirmed sepsis and poor outcomes.