Pediatric trauma: Where are we and where are we heading? A narrative review of recent evidence.

Trauma is the leading cause of death in children and adolescents. This article reviews recent advances in the management of severe pediatric trauma, emphasizing the importance of well-organized trauma systems, effective triage, and protocols specifically adapted to pediatric physiology. Current strategies for damage-control resuscitation are discussed, including the use of blood products, vasoactive support, and novel predictive indices for shock severity. In traumatic brain injury, the role of multimodal neuromonitoring and individualized management of intracranial and cerebral perfusion pressures is reviewed. The need to move beyond adult-centered approaches and tailor care to pediatric-specific characteristics is strongly emphasized. Finally, the main research priorities in pediatric trauma are outlined, which are essential for improving survival and functional recovery in this vulnerable population.