title: Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care.
abstract: OBJECTIVE
  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 (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD 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. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD 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 25OHD and C-reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04).
  
  
  CONCLUSIONS
  Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes.
authors.affiliation: Department of Paediatrics, National Maternity Hospital, Dublin, Ireland.|Department of Paediatrics, Children's University Hospital, Dublin, Ireland.|Department of Medicine & Medical Sciences, University College Dublin, Dublin, Ireland.
authors.forename: Chike
authors.initials: C
authors.lastname: Onwuneme
authors.affiliation: Department of Paediatrics, Children's University Hospital, Dublin, Ireland.
authors.forename: Aoife
authors.initials: A
authors.lastname: Carroll
authors.affiliation: Department of Paediatrics, Children's University Hospital, Dublin, Ireland.|Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Dermot
authors.initials: D
authors.lastname: Doherty
authors.affiliation: Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Heike
authors.initials: H
authors.lastname: Bruell
authors.affiliation: Department of Physiotherapy and Population Science, UCD CSTAR, University College Dublin, Dublin, Ireland.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Segurado
authors.affiliation: Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Mark
authors.initials: M
authors.lastname: Kilbane
authors.affiliation: Department of Paediatrics, Children's University Hospital, Dublin, Ireland.
authors.forename: Nuala
authors.initials: N
authors.lastname: Murphy
authors.affiliation: Department of Medicine & Medical Sciences, University College Dublin, Dublin, Ireland.|Department of Endocrinology, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Malachi J
authors.initials: MJ
authors.lastname: McKenna
authors.affiliation: Department of Paediatrics, National Maternity Hospital, Dublin, Ireland.|Department of Medicine & Medical Sciences, University College Dublin, Dublin, Ireland.|Department of Paediatrics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.|Department of Paediatrics, Royal College of Surgeons of Ireland, Dublin, Ireland.|Department of Paediatrics, Trinity College Dublin, National Children's Hospital, Tallaght & Coombe Women's and Infant's University Hospital, Dublin, Ireland.
authors.forename: Eleanor J
authors.initials: EJ
authors.lastname: Molloy
mesh_terms: D016470:Bacteremia / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007494:Ireland / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: C-reactive protein; Organ dysfunction; Paediatric intensive care; Sepsis; Vitamin D deficiency