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ObjectivesIn adult major trauma patients admission hypocalcaemia occurs in approximately half of cases and is associated with increased mortality. However, data amongst paediatric patients are limited. The objectives of this review were to determine the incidence of admission ionised hypocalcaemia in paediatric major trauma patients and to explore whether hypocalcaemia is associated with adverse outcomes.MethodsA systematic review was conducted following PRISMA guidelines. All studies including major trauma patients p ResultsThree retrospective cohort studies were included. Admission ionised hypocalcaemia definitions ranged from I2 39%, Cochrane’s Q p = 0.294) identified a non-significant (p = 0.122) estimate of hypocalcaemia increasing mortality (pooled OR 2.26, 95% CI 0.80–6.39). For the pH difference, meta-analysis supported generation of a pooled effect estimate (I2 57%, Cochrane’s Q p = 0.100). The effect estimate of the mean pH difference was not significantly different from null (p = 0.657), with the estimated pH slightly lower in hypocalcaemia (Glass D standardized mean difference -0.08, 95% CI -0.43 to 0.27).ConclusionAdmission ionised hypocalcaemia was present in at least one in six paediatric major trauma patients. Ionised hypocalcaemia was not identified to have a statistically significant association with mortality or pH difference.