The Paediatric Adaptive Sepsis Platform Trial (PASSPORT) is working to address one of the most urgent challenges in paediatric care – sepsis. A life-threatening emergency affecting children worldwide, sepsis is often poorly understood and can progress rapidly. Early symptoms may appear no different from common viral infections, making it difficult to recognise at the point when treatment is most effective.

“The paradox of sepsis is that it’s very difficult to pick up early, when children aren’t yet very sick. But that’s exactly when treatment is most effective,” explained Associate Professor Elliot Long, an emergency physician at the RCH and the sepsis research team lead at the Murdoch Children’s Research Institute (MCRI).

Sepsis occurs when the body’s response to infection becomes uncontrolled, leading to widespread inflammation and organ damage. For many children, by the time sepsis is clearly identified, they are already critically unwell, and the opportunity to prevent further deterioration may have passed.

“For any child with a fever that presents to hospital, we worry about sepsis. And for those children who are diagnosed, we have big questions about what the best and optimal treatments are for them because there isn’t enough high-quality evidence to inform our current practice,” explained Elliot.

This is why PASSPORT is so crucial. The lack of highquality evidence has resulted in a significant variation in how children with sepsis are treated. Using an innovative approach called an adaptive platform trial, PASSPORT offers a novel methodology for studying sepsis treatments. In order to explain the impact that an adaptive trial can have over a traditional trial, Elliot uses a familiar sporting analogy.

“Instead of building a new stadium for every game and then taking it down again, stadiums are built to hold many games over many years. Randomised trials are like building a new stadium for every game, and taking it down again. But in platform trials, the stadium exists in perpetuity,” Elliot explained.

This approach allows all the infrastructure – such as data systems, governance frameworks and expert research teams – to be reused across studies. As a result, multiple studies can run at the same time, with new ones added or stopped as needed, enabling treatment interventions to be tested more efficiently.

“With traditional trial methods, each study can take a decade and even longer to find answers to critical clinical questions. PASSPORT is designed to dramatically shorten that timeline,” Elliot emphasised.

Critically, PASSPORT will be taking a global approach, making an impact far beyond the walls of the RCH.

“We will be conducting the trial within Australia and New Zealand and are paving the way to scale the platform and this study internationally, with a focus on low- and middle-income countries,” he continued.

This study has the power to transform sepsis care for generations to come across the world. While PASSPORT is currently in its preparation and planning phase, the study is looking at the whole patient journey to improve outcomes in the long-term.

“The impact of PASSPORT will help improve the burden of illness for children with sepsis in Australia, but importantly also in low- and middle-income countries where the burden is the highest. Thank you to the RCH Foundation donors for helping get this platform off the ground. This places the RCH and MCRI at the forefront of using novel methods for addressing difficult-toresearch illnesses, such as sepsis,” Elliot concluded.