Making thawed universal donor plasma available rapidly for massively bleeding trauma patients: experience from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial

• DOI: 10.1111/trf.13098
• Publication Date: 2015-03-30T14:42:58Z
• Authors: Deborah J. Novak; Yu Bai; Rhonda K. Cooke; Marisa B. Marques; Magali J. Fontaine; Jerome L. Gottschall; Patricia M. Carey; Richard M. Scanlan; Eberhard W. Fiebig; Ira A. Shulman; Janice M. Nelson; Sherri Flax; Veda Duncan; Jennifer A. Danie...; Jeannie L. Callum; John B. Holcomb; Erin E. Fox; Sarah Baraniuk; Barbara C. Tilley; Martin A. Schreiber; Kenji Inaba; Sandro Rizoli; Jeanette M. Podbi...; Bryan A. Cotton; John R. Hess
• Keywords: Blood product

BACKGROUND The Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial was a randomized clinical comparing survival after transfusion of two different blood component ratios for emergency resuscitation traumatic massive hemorrhage. Transfusion services supporting the study were expected to provide thawed plasma, platelets, red cells within 10 minutes request. STUDY DESIGN AND METHODS At 12 Level 1 trauma centers participating in PROPPR, components transfused delivery times tabulated, with focus on universal donor (UD) plasma management. adequacy site plans assessed by bedside availability goals new American College Surgeons guidelines. RESULTS Eleven sites able consistently deliver 6 units UD their trauma‐receiving unit 20 minutes. Three used group A instead AB without complications. Approximately 4700 given 680 patients enrolled trial. No experienced shortages that limited enrollment. Two reported wastage approaching 25% prepared. CONCLUSION Delivering massively hemorrhaging accomplished rapidly excessive high‐volume centers. Trauma Quality Improvement Program guidelines protocol are practicable large academic Use needs further study.