different population groups to ensure public health campaigns remain responsive to community vaccine sentiments. Given the potential impact of vaccine hesitancy on the required population herd immunity threshold, we need to understand the attitudinal and behavioural drivers in order to inform community-led communication strategies to build trust and optimise COVID-19 vaccine uptake.We declare no competing interests.

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Objective: To identify risk factors associated with mortality in critically ill children requiring continuous renal replacement therapy. Design: Retrospective observational study based on a prospective registry. Setting: Tertiary and quaternary referral 30-bed PICU. Patients: Critically ill children undergoing continuous renal replacement therapy were included in the study. Interventions: Continuous renal replacement therapy. Measurements and Main Results: Overall mortality was 36% (n = 58) among the 161 patients treated with continuous renal replacement therapy during the study period and was significantly higher in patients on extracorporeal membrane oxygenation (47.5%, 28 of 59) than in patients not requiring extracorporeal membrane oxygenation (28.4%, 29 of 102; p = 0.022). According to the admission diagnosis, we found the highest mortality in patients with onco-hematologic disease (77.8%) and the lowest in patients with renal disease (5.6%). Based on multivariate logistic regression analysis, the presence of higher severity of illness score at admission (adjusted odds ratio, 1.49; 95% CI, 1.18–1.89; p < 0.001), onco-hematologic disease (odds ratio, 17.10; 95% CI, 4.10–72.17; p < 0.001), fluid overload 10%–20% (odds ratio, 3.83; 95% CI, 1.33–11.07; p = 0.013), greater than 20% (odds ratio, 15.03; 95% CI, 4.03–56.05; p < 0.001), and timing of initiation of continuous renal replacement therapy (odds ratio, 1.01; 95% CI, 1.00–1.01; p = 0.040) were independently associated with mortality. In our population, the odds of dying increases by 1% for every hour of delay in continuous renal replacement therapy initiation from ICU admission. Conclusions: Mortality in children requiring continuous renal replacement therapy remains high and seems to be related to the underlying disease, the severity of illness, and the degree of fluid overload. In critically ill children at high risk for developing acute kidney injury and fluid overload, earlier initiation of continuous renal replacement therapy might result in decreased mortality.

BACKGROUND Age-specific reference intervals (RIs) have been developed for biochemistry analytes in children. However, the ability to interpret results from multiple laboratories for 1 individual is limited. This study reports a head-to-head comparison of reference values and age-specific RIs for 30 biochemistry analytes for children across 5 analyzer types. METHODS Blood was collected from healthy newborns and children 30 days to &lt;18 years of age. Serum aliquots from the same individual were analyzed on 5 analyzer types. Differences in the mean reference values of the analytes by the analyzer types were investigated using mixed-effect regression analysis and by comparing maximum variation between analyzers with analyte-specific allowable total error reported in the Westgard QC database. Quantile regression was used to estimate age-specific RIs using power variables in age selected by fractional polynomial regression for the mean, with modification by sex when appropriate. RESULTS The variations of age-specific mean reference values between analyzer types were within allowable total error (Westgard QC) for most analytes, and common age-specific reference limits were reported as functions of age and/or sex. Analyzer-specific reference limits for all analytes on 5 analyzer types are also reported as functions of age and/or sex. CONCLUSIONS This study provides quantitative and qualitative measures of the extent to which results for individual children can or cannot be compared across analyzer types, and the feasibility of RI harmonization. The reported equations enable incorporation of age-specific RIs into laboratory information systems for improving evidence-based clinical decisions in children.