title: [Efficacy of high versus low plasma: red blood cell ratio resuscitation in patients with severe trauma requiring massive blood transfusion: a meta-analysis].
abstract: OBJECTIVE
  To evaluate the efficacy of high (≥1:2) and low (<1:2) plasma: red blood cell (RBC) ratio resuscitation in patients with severe trauma requiring massive blood transfusion.
  
  
  METHODS
  The databases including the Cochrane Library, Pubmed, Web of Science, and EMBASE were systemically searched for relevant studies published between January, 2009 and April, 2016. The selection of studies, assessment of methodological quality and data extraction were performed by two researchers independently according to the inclusion and exclusion criteria. The main endpoint was 24-h mortality, 30-day mortality and 24-h survival rate.
  
  
  RESULTS
  Five observational studies reporting outcomes of 1024 patients were included in this meta-analysis. Four studies documented civilian cases and one study had a military setting. No significant differences were found in the Injury Severity Score (ISS) between patient groups receiving high and low plasma: RBC ratio resuscitation. Compared with the low-ratio group, the patients with high-ratio resuscitation showed a significant reduction in the 24-h mortality rate (OR=0.35, 95%CI [0.25, 0.48], P<0.000 01) and the 30-day mortality rate (OR=0.55, 95%CI [0.41, 0.75], P=0.0001). An increased survival rate was observed in patients receiving high plasma: RBC ratio resuscitation within the initial 24 h following the trauma (HR=2.34, 95%CI [1.46, 3.73], P=0.00001).
  
  
  CONCLUSIONS
  Raising the plasma: RBC ratio to 0.5 or higher may decrease the mortality rate of the patients with severe trauma who need massive blood transfusion.
authors.affiliation: Department of Emergency Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail: soiphy@163.com.
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
authors.forename: Tao
authors.initials: T
authors.lastname: Zhong
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
mesh_terms: D001803:Blood Transfusion / Q000401:mortality; D004906:Erythrocyte Count; D004912:Erythrocytes / Q000166:cytology*; D006801:Humans; D015601:Injury Severity Score; D064887:Observational Studies as Topic; D010949:Plasma; D012151:Resuscitation; D012189:Retrospective Studies; D015996:Survival Rate; D014947:Wounds and Injuries / Q000097:blood* / Q000401:mortality