TY - JOUR
T1 - 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
AU - Rahouma, Mohamed
AU - Kamel, Mohamed
AU - Jodeh, Diana
AU - Kelley, Thomas
AU - Ohmes, Lucas B.
AU - de Biasi, Andreas R.
AU - Abouarab, Ahmed A.
AU - Benedetto, Umberto
AU - Guy, T. Sloane
AU - Lau, Christopher
AU - Lee, Paul C.
AU - Girardi, Leonard N.
AU - Gaudino, Mario
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: 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. Methods: 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. Results: In 36 studies, lower ratio showed poorer 24-h and 30-day survival (p < 0.001). In trauma and non-trauma settings, a lower ratio was associated with worse 24-h and 30-day mortality (P < 0.001). A ratio of 1:1.5 provided the largest 24-h and 30-day survival benefit (p < 0.001). The ratio was not associated with ARDS or ALI. Conclusions: High FFP:RBC ratio confers survival benefits in trauma and non-trauma settings, with the highest survival benefit at 1:1.5.
AB - Background: 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. Methods: 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. Results: In 36 studies, lower ratio showed poorer 24-h and 30-day survival (p < 0.001). In trauma and non-trauma settings, a lower ratio was associated with worse 24-h and 30-day mortality (P < 0.001). A ratio of 1:1.5 provided the largest 24-h and 30-day survival benefit (p < 0.001). The ratio was not associated with ARDS or ALI. Conclusions: High FFP:RBC ratio confers survival benefits in trauma and non-trauma settings, with the highest survival benefit at 1:1.5.
KW - 24-h and 30-day/in-hospital mortality
KW - Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) rates
KW - Fresh frozen plasma (FFP): packed red blood cell (RBC) ratio
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85030475914&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2017.08.045
DO - 10.1016/j.amjsurg.2017.08.045
M3 - Review article (Academic Journal)
C2 - 28969893
AN - SCOPUS:85030475914
VL - 216
SP - 342
EP - 350
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 2
ER -