Focus on paediatrics
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EDITORIAL
Focus on paediatrics Katherine L. Brown1,2* and Daniele De Luca3,4 © 2020 Springer-Verlag GmbH Germany, part of Springer Nature
The United Nations (UN) sustainable development goal 3.2 is to end preventable deaths in neonates and children under the age of 5 years by 2030. In this focus paper, we present an overview of studies related to critically ill children from 2019, which may help us to achieve this important UN goal. 1. Clinical trials update We selected five high-quality clinical trials published from acute neonatal and paediatric settings, two from low- and middle-income countries (LMIC) and three from high-income countries, focussed on transfusion and respiratory support. (a) Resource poor settings. An international study mapped 123 million child deaths, demonstrating that 93% occur in LMIC [1]. Although mortality under the age of 5 years fell (as we shown in Fig. 1), ‘58% of deaths could have been averted in the absence of geographical inequalities’ [1]. While many of these deaths might be from vaccine preventable infectious diseases, a significant proportion might also be prevented by better acute care, hence the focus of this editorial. The TRACT group undertook an open-label randomised controlled trial (RCT) comparing high-volume (30 ml kg−1) with low-volume (20 ml kg−1) transfusion, as currently recommended by WHO, in 3196 children admitted to hospitals in Uganda and Malawi with severe anaemia (haemoglobin
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