• Daisuke Kudo, Junichi Sasaki, Satoshi Akaishi, Satoshi Yamanouchi, Tomoaki Koakutsu, Tomoyuki Endo, Takeaki Sato, Ryosuke Nomura, Hironao Yuzawa, Michio Kobayashi, Yotaro Shinozawa, and Shigeki Kushimoto.
• Emergency Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan, kudodaisuke@med.tohoku.ac.jp.
• Surg. Today. 2014 Apr 1;44(4):653-61.

PurposeRecent studies have shown increased survival benefits when a high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratio is used during trauma resuscitation. However, some reports have raised questions about the effect of higher FFP:PRBC transfusion ratios. The aim of this study was to examine the efficacy of high FFP:PRBC ratios in injured patients with regard to survival and morbidity in a single tertiary emergency center in Japan.MethodsThis study examined severe trauma patients who received 10 or more PRBC units during the first 24 h of admission. We examined the relationship between the FFP:PRBC ratios during the first 6 h and the patient outcome.ResultsThe severity was similar among all groups. The mortality rate was 44.4% in the high (>1:1.5), 16.7% in the middle (1:1.5-1:2) and 33.3% in the low (<1:2) F:P ratio groups. Only one patient in the high group developed sepsis, and none of the patients developed ARDS.ConclusionsThe current results indicate that the FFP:PRBC ratios during the first 6 h after admission might not affect the mortality or morbidity. However, differences between trauma care systems in Japan and other countries, along with other study limitations, necessitate that a subsequent prospective multicenter study be undertaken before any definitive conclusions can be made.

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