Plasma/platelets/red blood cell ratio in the management of the bleeding traumatized patient:  does it matter?
OBJECTIVE
The scope of this review is to describe what is known about blood product ratios and their effects on acute trauma coagulopathy. Assessing how ratios matter to trauma patients is important to improve massive transfusion strategies.


RESULTS
A growing body of evidence supports that high ratios of fresh frozen plasma and platelets to red blood cells improve survival of the massively bleeding traumatized patient. Acting quickly is also critical. Reducing transfusion delay can be achieved through massive transfusion protocol implementations, which incorporate local agreements with blood banks and 'trauma packs' in organized trauma systems. Thawed plasma and freeze-dried plasma allow immediate delivery of plasma.


CONCLUSIONS
Fresh frozen plasma/platelet/red blood cell ratios matter to define the content of packs immediately available within the golden hour to the right, accurately screened trauma patients. Research is needed in developing novel transfusion approaches for massively bleeding patients.
Department of Anesthesia and Critical Care, Hôtel-Dieu and Cochin Hospitals, Paris Descartes University, Paris, France. anne.godier@htd.aphp.fr
Anne
A
Godier
Charles-Marc
CM
Samama
Sophie
S
Susen
D000208:Acute Disease; D016913:Blood Component Transfusion / Q000379:methods*; D017707:Erythrocyte Transfusion; D006470:Hemorrhage / Q000097:blood / Q000628:therapy*; D006801:Humans; D010949:Plasma; D017713:Platelet Transfusion; D014947:Wounds and Injuries / Q000097:blood / Q000628:therapy*