Abstract
Trauma remains a leading cause of preventable mortality and disability worldwide, particularly among young adults, with hemorrhagic shock and trauma-induced coagulopathy contributing significantly to early deaths and poor long-term outcomes. Over the past two decades, trauma resuscitation has evolved from crystalloid-dominant approaches toward evidence-based strategies focused on rapid hemorrhage control, balanced transfusion protocols, hemostatic resuscitation, and physiologic optimization. This PRISMA-informed narrative review evaluates recent advances in trauma resuscitation and their effects on mortality and functional recovery. A comprehensive literature search was conducted using PubMed, Scopus, and Embase databases to identify studies published between 2010 and 2026 related to trauma resuscitation and patient outcomes. Search terms included trauma resuscitation, hemorrhagic shock, damage-control resuscitation, massive transfusion, tranexamic acid, resuscitative endovascular balloon occlusion of the aorta (REBOA), and point-of-care coagulation testing. Priority was given to randomized controlled trials, systematic reviews, meta-analyses, observational studies, and evidence-based trauma guidelines. Current evidence demonstrates that balanced massive transfusion strategies, early administration of tranexamic acid, and rapid hemorrhage-control interventions are associated with significant reductions in early mortality and improved hemodynamic stabilization in severely injured patients. Point-of-care diagnostics and viscoelastic coagulation testing facilitate individualized transfusion management and may reduce unnecessary blood product utilization and transfusion-related complications. Emerging technologies such as predictive analytics and artificial intelligence-assisted decision-support systems show promise in improving triage accuracy and early recognition of clinical deterioration, although challenges related to validation, implementation, and resource availability remain. Despite substantial advances in trauma care, important disparities persist, particularly in low-resource settings where access to blood products, advanced diagnostics, and specialized personnel remains limited. Continued research, multidisciplinary training, and strengthening of trauma systems are essential for improving global trauma outcomes and reducing preventable mortality

Key words: Trauma resuscitation; Hemorrhagic shock; Damage-control resuscitation; Massive transfusion; Tranexamic acid; REBOA; Point-of-care diagnostics; Trauma systems.