Liquid plasma use during “super” massive transfusion protocol

Abstract Background A massive transfusion protocol (MTP) presents a logistical challenge for most blood banks and trauma centers. We compare the ratio of packed red blood cells (PRBC) and plasma transfused over serial time points in those requiring MTP (10–30 U PRBC/24 h) to those requiring “super” MTP (S-MTP; >30 U PRBC/24 h) and test the hypothesis that changes in allocation of blood products with use of readily transfusable liquid plasma (LP) improves the ratio of PRBC and plasma during S-MTP. Materials and methods All transfused trauma patients ( n = 1305) from January 01, 2009–April, 03, 2015 were reviewed. PRBC:plasma ratio was compared for MTP ( n = 277) and S-MTP ( n = 61) patients, before and after the availability of LP at our institution. Data are reported as mean ± standard deviation or median (interquartile range). Results Age was 41 ± 19 y, 52% blunt mechanism, injury severity score 32 ± 16, and 46.3% mortality. In 24 h, requirements were 17 (14) U PRBC and 10 (11) U plasma, with a PRBC:plasma of 1.6 (0.8). Within the first hour, PRBC:plasma for S-MTP versus MTP was 2.1:1 versus 1.7:1 ( P = 0.017). With LP, S-MTP patients received significantly lower PRBC:plasma at the first hour ( P