Volume of Crystalloid During Massive Transfusion Is Associated with Increased Mortality

Multiple studies have demonstrated the benefits of high-ratio resuscitation (1 unit fresh frozen plasma to 1–2 units packed red blood cells) for severely injured trauma patients requiring massive transfusion. In a retrospective multi-institutional study of adult trauma patients who required massive transfusion, researchers compared outcomes between 365 patients who received high-ratio resuscitation and 85 who received low-ratio resuscitation (<1 unit fresh frozen plasma to 2 units packed red blood cells), and assessed the correlation between total crystalloid volume infused and outcomes. All patient received >10 units of packed red blood cells during the first 24 hours.

Patients receiving high-ratio resuscitation had better outcomes than tho…