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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
- Source :
- Rahouma, M, Kamel, M, Jodeh, D, Kelley, T, Ohmes, L B, de Biasi, A R, Abouarab, A A, Benedetto, U, Guy, T S, Lau, C, Lee, P C, Girardi, L N & Gaudino, M 2018, ' 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 ', American Journal of Surgery, vol. 216, no. 2, pp. 342-350 . https://doi.org/10.1016/j.amjsurg.2017.08.045
- Publication Year :
- 2018
-
Abstract
- 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.
- Subjects :
- medicine.medical_specialty
Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) rates
030204 cardiovascular system & hematology
Lung injury
Global Health
law.invention
03 medical and health sciences
Plasma
24-h and 30-day/in-hospital mortality
0302 clinical medicine
Postoperative Complications
Randomized controlled trial
law
Internal medicine
medicine
Humans
Blood Transfusion
Shock, Traumatic
Hospital Mortality
Intensive care medicine
Randomized Controlled Trials as Topic
business.industry
packed red blood cell (RBC) ratio [Fresh frozen plasma (FFP)]
030208 emergency & critical care medicine
General Medicine
Prognosis
Survival Rate
Red blood cell
Observational Studies as Topic
Meta-analysis
medicine.anatomical_structure
Cohort
Surgery
Observational study
Fresh frozen plasma
Packed red blood cells
business
Erythrocyte Transfusion
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Rahouma, M, Kamel, M, Jodeh, D, Kelley, T, Ohmes, L B, de Biasi, A R, Abouarab, A A, Benedetto, U, Guy, T S, Lau, C, Lee, P C, Girardi, L N & Gaudino, M 2018, ' 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 ', American Journal of Surgery, vol. 216, no. 2, pp. 342-350 . https://doi.org/10.1016/j.amjsurg.2017.08.045
- Accession number :
- edsair.doi.dedup.....5f2b1f8b3d82a6274cd0de774e00db35