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Transfusion of plasma, platelets, and Red Blood Cells in a 1:1:1 versus a 1:1:2 Ration and Mortality in Patients with Severe Trauma: The PROPPR Randomized Clinical Trial 

Transfusion of plasma, platelets, and Red Blood Cells in a 1:1:1 versus a 1:1:2 Ration and Mortality in Patients with Severe Trauma: The PROPPR Randomized Clinical Trial
Chapter:
Transfusion of plasma, platelets, and Red Blood Cells in a 1:1:1 versus a 1:1:2 Ration and Mortality in Patients with Severe Trauma: The PROPPR Randomized Clinical Trial
Author(s):

Yuk Ming Liu

, and Kathryn Butler

DOI:
10.1093/med/9780190467654.003.0041
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date: 20 April 2019

This chapter provides a summary of the landmark study known as the PROPPR trial. How effective and safe is rapid transfusion of patients with severe traumatic hemorrhage using plasma, platelets, and red blood cells in a 1:1:1 ratio compared to a 1:1:2 ratio? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. A growing body of literature suggests that massive transfusion protocols confer mortality benefits for trauma patients in hemorrhagic shock; however, such protocols still require standardization. In the PROPPR trial, there was suggestion of improved hemostasis and less death from exsanguinations with a 1:1:1 transfusion ratio versus a 1:1:2 approach; however, further trials are warranted.

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