Hemostatic resuscitation with plasma and platelets in trauma
Journal of Emergencies, Trauma and Shock,
Johansson PI et al. – Meta–analysis of 16 retrospective studies concerning massively transfused trauma patients confirms a significantly lower mortality in patients treated with the highest fresh frozen plasma (FFP) and/or platelets (PLT) ratio when compared with the lowest FFP and/or PLT ratio. However, optimal ranges of FFP: RBC and PLT : RBC should be established in randomized controlled trials.Methods
- English databases were searched for reports of trauma patients receiving massive transfusion (10 or more red blood cell (RBC) within 24hours or less from admission) that tested the effects of administration of plasma and/or PLT in relation to RBC concentrates on survival from January 2005 to November 2010.
- Comparison between highest vs lowest blood product ratios and 30–day mortality was performed.
- Sixteen studies encompassing 3,663 patients receiving high vs low ratios were included.
- This meta–analysis of the pooled results revealed a substantial statistical heterogeneity (I2=58%) and that the highest ratio of plasma and/or PLT or to RBC was associated with a significantly decreased mortality (OR: 0.49; 95% confidence interval: 0.43–0.57; P<0.0001) when compared with lowest ratio.