Association Between Initial Blood Product Transfusion with a Higher Plasma-to-red Blood Cell Ratio and Mortality in Adults with Severe Bleeding Following Trauma

journals.lww.com April 23, 2025

This study demonstrates that a high fresh-frozen plasma (FFP) to packed red blood cells (PRBC) ratio (>1:1.5) is associated with reduced 24-hour and 30-day mortality rates among trauma patients with massive hemorrhage. However, the need for mechanical ventilation in some high-ratio patients suggests potential trade-offs that warrant further investigation.

Additional research is needed to explore the potential adverse effects of high FFP:PRBC ratios and to optimize transfusion strategies in trauma care.

Among 300 patients with a mean age of 40.5 years, 231 (76.7%) were male, and 69 (22.9%) were females.

The high FFP:PRBC ratio group showed significantly higher rates of 24-hour mortality (11.5%), 30-day mortality (45.9%), and ICU admission (P < 0.001).