Background: Sepsis is a life-threatening condition characterized by a dysregulated systemic inflammatory response to infection. Vitamin A is an essential micronutrient that plays an important immunomodulatory role. Emerging evidences suggests that vitamin A deficiency (VAD) may had a significant potential for the development and progression of sepsis.

Aim: to assess VAD prevalence in septic critically ill paediatric patients, and its effect on their clinical outcomes.

Patients and methods: This is a cross-sectional study that included two groups; a group of 37 critically ill children with sepsis, and control group of 37 non critically ill children attending to the outpatient clinics. Full history and clinical examination were done to the patients, in addition patients of both groups were screened for serum vitamin A levels.

Results: We found that VAD was significantly higher in critically ill children with sepsis (n = 10) compared to the controls group (n=0, p < 0.001). Also, most of vitamin A deficient patients had increased pediatric risk of mortality (PRISM) III scores at time of the paediatric intensive care unit (PICU) admission (P < 0.001), and all of them died in the follow-up compared to patients with normal vitamin A levels.

Conclusion: Vitamin A deficiency was linked to sepsis severity and higher PRISM III score at PICU admission for critically ill pediatric patients. In addition, serum vitamin A level may be used as a marker for predicting mortality in those septic critically ill pediatric patients.