Authors
John B Holcomb, Barbara C Tilley, Sarah Baraniuk, Erin E Fox, Charles E Wade, Jeanette M Podbielski, Deborah J del Junco, Karen J Brasel, Eileen M Bulger, Rachael A Callcut, Mitchell Jay Cohen, Bryan A Cotton, Timothy C Fabian, Kenji Inaba, Jeffrey D Kerby, Peter Muskat, Terence O’Keeffe, Sandro Rizoli, Bryce RH Robinson, Thomas M Scalea, Martin A Schreiber, Deborah M Stein, Jordan A Weinberg, Jeannie L Callum, John R Hess, Nena Matijevic, Christopher N Miller, Jean-Francois Pittet, David B Hoyt, Gail D Pearson, Brian Leroux, Gerald van Belle, PROPPR Study Group
Publication date
2015/2/3
Journal
Jama
Volume
313
Issue
5
Pages
471-482
Publisher
American Medical Association
Description
Importance
Severely injured patients experiencing hemorrhagic shock often require massive transfusion. Earlier transfusion with higher blood product ratios (plasma, platelets, and red blood cells), defined as damage control resuscitation, has been associated with improved outcomes; however, there have been no large multicenter clinical trials.
Objective
To determine the effectiveness and safety of transfusing patients with severe trauma and major bleeding using plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio.
Design, Setting, and Participants
Pragmatic, phase 3, multisite, randomized clinical trial of 680 severely injured patients who arrived at 1 of 12 level I trauma centers in North America directly from the scene and were predicted to require massive transfusion between August 2012 and December 2013.
Interventions
Blood product ratios of 1:1:1 (338 patients) vs 1:1:2 (342 patients …
Scholar articles
JB Holcomb, BC Tilley, S Baraniuk, EE Fox, CE Wade… - Jama, 2015