Background: Literature is scarce on the assessment of vitamin E status in septic children. We aim to investigate the prevalence of vitamin E deficiency in critically ill children with sepsis and septic shock and its association with clinical features and outcomes. Methods: We compared serum vitamin E status between the confirmed or suspected infection and no infection groups, the sepsis shock and no sepsis shock groups upon pediatric intensive care unit admission. Clinical characteristics were compared in subgroup patients with and without vitamin E deficiency. The association between vitamin E deficiency and septic shock were evaluated using univariate and multivariable methods. Results: 182 critically ill children with confirmed or suspected infection and 114 without infection were enrolled. The incidence of vitamin E deficiency was 30.2% in the infection group and 61.9% in the septic shock subgroup (P < 0.001). 30-days mortality in critically ill children with vitamin E deficiency was significantly higher than that without vitamin E deficiency (27.3%, vs. 14.2%, P < 0.05). Vitamin E levels were inversely associated with higher pediatric risk of mortality (r = − 0.238, P = 0.001) and cardiovascular sequential organ failure assessment (r= -0.249, p<0.001) scores in critically ill children with infection. In multivariable logistic regression, vitamin E deficiency showed an independent effect on septic shock (adjusted OR：6.749, 95%CI: 2.449-18.60, P<0.001). Conclusion: Vitamin E deficiency is highly prevalent in critically ill children with sepsis and contributed to the septic shock.

中文翻译：

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维生素E缺乏与重症儿童败血症和败血性休克之间的关系

背景：关于脓毒症儿童维生素E状况的评估文献稀少。我们旨在调查脓毒症和败血性休克危重病患儿中维生素E缺乏症的患病率及其与临床特征和结局的关系。方法：我们比较了接受小儿重症监护病房的确诊或疑似感染与无感染组，败血症休克和无败血症休克组之间的血清维生素E状况。比较有和没有维生素E缺乏症的亚组患者的临床特征。使用单变量和多变量方法评估维生素E缺乏症和败血性休克之间的关系。结果：182例确诊或怀疑感染的危重病儿童和114例未感染的危重儿童入组。维生素E缺乏症的发生率为30。感染组为2％，败血性休克亚组为61.9％（P <0.001）。患有维生素E缺乏症的重症儿童30天死亡率显着高于没有维生素E缺乏症的重症儿童（27.3％，vs. 14.2％，P <0.05）。在感染重症患儿中，维生素E水平与较高的儿科死亡率（r = − 0.238，P = 0.001）和心血管序贯器官衰竭评估（r = -0.249，p <0.001）得分呈负相关。在多因素logistic回归分析中，维生素E缺乏症对败血性休克具有独立影响（校正OR：6.749，95％CI：2.449-18.60，P <0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。患有维生素E缺乏症的重症儿童30天死亡率显着高于没有维生素E缺乏症的重症儿童（27.3％，vs. 14.2％，P <0.05）。在感染重症患儿中，维生素E水平与较高的儿科死亡率（r = − 0.238，P = 0.001）和心血管序贯器官衰竭评估（r = -0.249，p <0.001）得分呈负相关。在多因素logistic回归分析中，维生素E缺乏症对败血性休克具有独立影响（校正OR：6.749，95％CI：2.449-18.60，P <0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。患有维生素E缺乏症的重症儿童30天死亡率显着高于没有维生素E缺乏症的重症儿童（27.3％，vs. 14.2％，P <0.05）。在感染重症患儿中，维生素E水平与较高的儿科死亡率（r = − 0.238，P = 0.001）和心血管序贯器官衰竭评估（r = -0.249，p <0.001）得分呈负相关。在多因素logistic回归分析中，维生素E缺乏症对败血性休克具有独立影响（校正OR：6.749，95％CI：2.449-18.60，P <0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。在感染重症患儿中，维生素E水平与较高的儿科死亡率（r = − 0.238，P = 0.001）和心血管序贯器官衰竭评估（r = -0.249，p <0.001）得分呈负相关。在多因素logistic回归分析中，维生素E缺乏症对败血性休克具有独立影响（校正OR：6.749，95％CI：2.449-18.60，P <0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。在感染重症患儿中，维生素E水平与较高的儿科死亡率（r = − 0.238，P = 0.001）和心血管序贯器官衰竭评估（r = -0.249，p <0.001）得分呈负相关。在多因素logistic回归分析中，维生素E缺乏症对败血性休克具有独立影响（校正OR：6.749，95％CI：2.449-18.60，P <0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。749，95％CI：2.449-18.60，P ＜0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。749，95％CI：2.449-18.60，P ＜0.001）。结论：维生素E缺乏症在重症脓毒症患儿中非常普遍，并导致败血症性休克。