Does a balanced transfusion ratio of plasma to packed red blood cells improve outcomes in both trauma and surgical patients? A meta-analysis of randomized controlled trials and observational studies

The effect of high transfusion ratios of fresh frozen plasma (FFP): packed red blood cell (RBC) on mortality is still controversial. Observational evidence contradicts a recent randomized controlled trial regarding mortality benefit. This is an updated meta-analysis, including a non-trauma cohort. P...

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Bibliographic Details
Published in:The American journal of surgery 2018-08, Vol.216 (2), p.342-350
Main Authors: Rahouma, Mohamed, Kamel, Mohamed, Jodeh, Diana, Kelley, Thomas, Ohmes, Lucas B., de Biasi, Andreas R., Abouarab, Ahmed A., Benedetto, Umberto, Guy, T. Sloane, Lau, Christopher, Lee, Paul C., Girardi, Leonard N., Gaudino, Mario
Format: Article
Language:English
Subjects:
24-h and 30-day/in-hospital mortality
Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) rates
Age
Aneurysms
Armed forces
Blood products
Blood Transfusion - methods
Clinical trials
Erythrocyte Transfusion - methods
Erythrocytes
Fresh frozen plasma (FFP): packed red blood cell (RBC) ratio
Gender
Global Health
Hemorrhage
Hospital Mortality - trends
Humans
Injury analysis
Lungs
Meta-analysis
Mortality
Observational studies
Observational Studies as Topic
Ostomy
Patients
Plasma
Postoperative Complications - mortality
Postoperative Complications - therapy
Prognosis
Randomization
Randomized Controlled Trials as Topic
Respiratory distress syndrome
Shock, Traumatic - mortality
Shock, Traumatic - therapy
Studies
Surgery
Survival
Survival Rate - trends
Transfusion
Trauma
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Summary:The effect of high transfusion ratios of fresh frozen plasma (FFP): packed red blood cell (RBC) on mortality is still controversial. Observational evidence contradicts a recent randomized controlled trial regarding mortality benefit. This is an updated meta-analysis, including a non-trauma cohort. Patients were grouped into high vs. low based on FFP:RBC ratio. Primary outcomes were 24-h and 30-day/in-hospital mortality. Secondary outcomes were acute respiratory distress syndrome and acute lung injury rates. Random model and leave-one-out-analyses were used. In 36 studies, lower ratio showed poorer 24-h and 30-day survival (p 
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.08.045