Literature Review - Pediatric poly-trauma (PICO)

Abstract

Objective: This review synthesizes current evidence (2020-2025) on the management and outcomes of pediatric polytrauma. It examines the effectiveness of pediatric-specific trauma systems and resuscitation strategies compared to adult-oriented or standard care, focusing on mortality, functional outcomes, and system-level improvements.

Methods: A literature review was conducted following a PICO framework, analyzing recent studies, meta-analyses, and consensus guidelines. The population of interest was children and adolescents (0-18 years) with polytrauma. The intervention was pediatric-specific trauma care, compared to adult-based or mixed care. Key outcomes included mortality, neurological function, and long-term morbidity.

Findings: Pediatric polytrauma has distinct patterns and physiological considerations compared to adults. Evidence confirms that organized, pediatric-specific trauma systems improve critical process measures like faster time to transfusion and better adherence to guidelines. However, conclusive evidence linking these systems directly to uniform reductions in mortality is mixed, with outcomes heavily influenced by institutional experience and resources. Promising clinical interventions, such as whole-blood transfusion, show potential but require further validation in pediatric populations. A significant gap exists in long-term and psychosocial outcome data for child survivors.

Conclusion: Successful management of pediatric polytrauma requires age-specific systems and protocols. While pediatric-focused care enhances the quality and coordination of acute treatment, more robust research is needed to definitively prove its impact on survival and to develop evidence-based guidelines for critical interventions like transfusion and imaging.