ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2026
The Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL): Turning Pediatric Critical Care Practice Into Clinical Research.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Inconsistency in Fluid Balance Calculations in UK Paediatric Intensive Care Units: A Short Research Report.Nursing in critical care · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the rationale, design, and implementation of the Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL), a novel approach to embed adaptive clinical research within routine pediatric critical care practice.
designProspective, multicenter, Bayesian adaptive platform trial developed by the U.K. Paediatric Critical Care Society Study Group (PCCS-SG) and funded by the U.K. National Institute for Health and Care Research Health Technology Assessment program.
settingA minimum of 20 of the 33 PICUs across the United Kingdom that participating in the PCCS-SG research network. PATIENTS: Critically ill children admitted to a PICU requiring support for one or more organ systems.
interventionsEligible patients will be randomized across multiple concurrent intervention domains. Each domain will test clinically relevant therapies where practice variation and evidence gaps exist. The adaptive Bayesian design allows dynamic modification of randomization ratios, dropping of inferior interventions, and addition of new domains over time. MEASUREMENTS AND MAIN
resultsThe primary outcome, common to all domains, is days alive and free of organ support to day 30. Trial efficiency and inclusivity are enhanced using routinely collected national registry data from the Paediatric Intensive Care Audit Network, real-time electronic health record integration, and a proportionate consent model. Extensive statistical simulations will inform decision rules for superiority, futility, and equivalence.
conclusionsPIVOTAL aims to bridge the gap between clinical care and research, providing a sustainable infrastructure to deliver timely, inclusive, and practice-changing evidence in pediatric critical care. Recruitment started in March 2026.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.