In an era of tremendous medical advancements, it is important to characterise and address inequities in the provision of health care and in outcomes. There is a large body of evidence describing such disparities by race or ethnicity and socioeconomic position in critically ill adults; however, this important issue has received less attention in children and adolescents (aged ≤21 years). This Review presents a summary of the available evidence on disparities in outcomes in paediatric critical illness in the USA as a result of racism and socioeconomic privilege. The majority of evidence of racial and socioeconomic disparities in paediatric critical care originates from the USA and is retrospective, with only one prospective intervention-based study. Although there is mixed evidence of disparities by race or ethnicity and socioeconomic position in general paediatric intensive care unit admissions and outcomes in the USA, there are striking trends within some disease processes. Notably, there is evidence of disparities in management and outcomes for out-of-hospital cardiac arrest, asthma, severe trauma, sepsis, and oncology, and in families’ perceptions of care. Furthermore, there is clear evidence that critical care research is limited by under-enrolment of participants from minority race or ethnicity groups. We advocate for rigorous research standards and increases in the recruitment and enrolment of a diverse range of participants in paediatric critical care research to better understand the disparities observed, including the effects of racism and poverty. A clearer understanding of when, where, and how such disparities affect patients will better enable the development of effective strategies to inform practice, interventions, and policy.

在医学取得巨大进步的时代，重要的是要描述和解决医疗保健提供和结果方面的不公平现象。有大量证据描述了重症成人在种族或族裔和社会经济地位方面的差异；然而，这一重要问题在儿童和青少年（≤21 岁）中受到的关注较少。本综述总结了美国因种族主义和社会经济特权而导致的儿科危重疾病结局差异的现有证据。儿科重症监护中种族和社会经济差异的大多数证据来自美国，并且是回顾性的，只有一项基于前瞻性干预的研究。尽管种族或族裔和社会经济地位在美国一般儿科重症监护病房入院和结果方面存在差异的证据不一，但在某些疾病过程中存在显着的趋势。值得注意的是，有证据表明院外心脏骤停、哮喘、严重创伤、败血症和肿瘤的管理和结果存在差异，以及家庭对护理的看法存在差异。此外，有明确的证据表明，重症监护研究受到少数种族或族裔参与者人数不足的限制。我们提倡严格的研究标准，并在儿科重症监护研究中招募和招募各种参与者，以更好地了解观察到的差异，包括种族主义和贫困的影响。更清楚地了解何时，