Plasma to Packed Red Cell Transfusion Ratio Associated with Mortality in Trauma

Using ratios closer to those resembling whole blood may make sense, but this study has too many limitations to be part of the evidence.

Hemorrhage remains a leading cause of death after trauma, and resuscitation strategies continue to evolve. A single prospective randomized trial comparing two ratios of fresh frozen plasma (FFP) to packed red blood cells (PRBC) found no differences in 24-hour or 30-day survival between groups (NEJM JW Emerg Med Mar 2015 and JAMA 2015; 313:471), but the optimal combination of blood components remains unsettled.

Using a French trauma registry, researchers retrospectively compared outcomes between patients who received at least two units of FFP for every three units of PRBC and patients who received a lower ratio of FFP to PRBC. Of 897 patients, 34% died within 30 days (the primary outcome). After adjustment for important confounders, use of th…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)