2025 Practice-changing articles in trauma, emergency general surgery, pediatric trauma, and surgical critical care: an EAST narrative review.

Trauma, acute care surgery, and surgical critical care clinicians routinely manage patients in whom small differences in timing, technique, and patient selection can meaningfully influence outcomes. Each year, emerging literature refines clinical decision-making across trauma surgery, emergency general surgery, pediatric trauma, and surgical critical care. A narrative review of the literature was conducted with primary emphasis on studies published in 2025. Selected high-impact articles from 2024 were included when they directly informed contemporary practice. Articles were identified through a structured review of the tables of contents of 17 high-impact general medical, surgical, trauma, and critical care journals and were supplemented by key articles known to the author group based on subject-matter expertise. The search was conducted between June 3, 2025, and December 31, 2025, and was limited to English-language publications. Priority was given to randomized clinical trials and large multicenter observational studies, with additional consideration of methodological rigor, citation impact, and journal-recognized distinctions. Thirteen studies were included, encompassing randomized trials, multicenter cohorts, and observational studies. These investigations addressed critical decision points across the continuum of care, including early resuscitation strategies, timing of life-saving interventions, analgesia and sedation, ventilator management, infection prevention, transfusion timing, perioperative antibiotics, diagnostic imaging strategies in older adults, and diagnostic and management pathways in pediatric trauma. Recent literature supports incremental refinement of trauma, acute care surgery, and surgical critical care practice, emphasizing selective application of established interventions, appropriate timing, and patient-centered decision-making. Collectively, these studies advance a more deliberate, evidence-informed approach to care across trauma surgery, emergency general surgery, pediatric trauma, and surgical critical care. Level of evidence Narrative review.