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Trauma resuscitation has evolved to include limited crystalloid early-transfusion strategies, with an increasing focus on early administration of plasma. Two recent studies randomized prehospital trauma patients to either 2 units of thawed plasma or standard care (crystalloid fluids). The helicopter-based PAMPer trial (NEJM JW Emerg Med Sep 2018 and N Engl J Med 2018 Jul 26; 379:315) found a nearly 10% mortality benefit with plasma, whereas the ambulance-based COMBAT study (NEJM JW Emerg Med Sep 2018 and Lancet 2018 Jul; 392:283) found no difference in mortality. One hypothesis for this difference in findings is the disparity in transport times between studies.
Researchers combined data from these two trials and analyzed outcomes for 626 uns…