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Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information
Feifei Jin1,2,3, Shu Li4, Xuemin Zhang5
1Trauma Medicine Center, Peking University People's Hospital, Beijing, China.
Abstract:
Severe trauma continues to rank among the leading causes of mortality and permanent disability globally, posing an intractable public health challenge that mandates prompt sophisticated and multidisciplinary intervention. Notably, the "Chinese model" has evolved into a transformative paradigm designed to optimize the efficiency of prehospital and in-hospital trauma rescue systems. This review presents a comprehensive analysis of paradigm-shifting advances in the management of severe trauma. We systematically scrutinize the latest clinical and translational evidence underpinning life-saving resuscitation strategies, with a particular focus on the paradigm shift from aggressive crystalloid-based resuscitation to hemostatic damage control resuscitation Furthermore, we delve into innovations in core damage control techniques encompassing hemorrhage control, decompression of compartment syndromes, skeletal stabilization, and surgical source control of contamination. We also evaluate the revolutionary impact of information technology and artificial intelligence on streamlining trauma care workflows, from prehospital triage to postdischarge follow-up. Additionally, through a cross-country comparison of trauma system configurations, we address the pivotal role of standardized quality control metrics and centralized trauma registries in mitigating regional disparities in trauma care outcomes. By synthesizing these cutting-edge developments, this review endeavors to explore future directions for the construction of a more resilient and intelligent high-performance trauma care system. Looking ahead, the integration of advanced technologies, personalized medicine, and cross-border collaboration holds promise for further enhancing trauma care efficiency and equity, ensuring that trauma systems evolve to meet the challenges of increasingly complex and dynamic healthcare environments.
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