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[Comment] Pragmatic trials in critically ill children are CATCHing on

The many barriers impeding performance of clinical trials in critically ill children1 have resulted in a paucity of evidence guiding bedside practice.2 Children admitted to a paediatric intensive care unit are heterogeneous. Not only does age vary (ie, from newborn babies to adolescents), but also the broad causes of illness include congenital disorders, recovery from surgery, neurological emergencies, overwhelming infections, and traumatic injuries. Traditional explanatory trials are designed to test causal research hypotheses by assessing a tightly controlled intervention in a selected subgroup of patients.