Citation

Dobson GP, Morris JL, Letson HL. Crit. Care 2024; 28(1): e135.

Copyright

(Copyright © 2024, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13054-024-04913-3

PMID

38654282

Abstract

We read with interest the perspective of Juffermans and colleagues on transforming research to improve therapies for trauma care in the twenty-first century [1]. We would like to offer a different perspective. We think a more interesting approach is to ask how historians of science 50 or 100 years from now might view our progress in the early twenty-first century? Instead of looking into the future from where we stand today, we move the needle into the future and reflect backwards. We agree with Juffermans and colleagues that specific treatments for bleeding are largely lacking [1], however, they fail to delve deeper. Why are there so few safe and effective drugs to treat hemorrhage, traumatic brain injury or burn trauma? Why have there been so few breakthroughs? We argue the lack of drug therapies is a consequence of the treat-as-you-go symptoms-based approach, rather than a more integrated systems-based approach [2, 3]. The current practice of identifying and treating one defect at a time, and so on down the line, often leads to what US trauma surgeon William C. Shoemaker deemed: "an uncoordinated and sometimes contradictory therapeutic outcome" [4]. In the twenty-first century, a new revolution is required to better understand how the body responds to trauma, identify new markers to detect its progression and discover new system-acting drugs to treat it. ...

Language: en

Keywords

*Wounds and Injuries/therapy; Biomedical Research/trends/methods; Humans