During massive transfusion, the recommended ratio of FFP:platelets:packed RBCs in the empirical damage-control resuscitation (DCR) approach is approximately:

• A 1:1:10 (FFP:platelets:pRBC)
• B 2:1:4 (FFP:platelets:pRBC)
• C 0:0:6 — only pRBC until Hb <7 g/dL
• D 1:1:1 (FFP:platelets:pRBC) ✓

Explanation

Damage-control resuscitation (DCR) for haemorrhagic shock employs a 1:1:1 ratio of FFP:platelets:pRBC to approximate the composition of whole blood and prevent the lethal triad of coagulopathy, hypothermia, and acidosis. Evidence from PROPPR trial demonstrated that a 1:1:1 ratio improved 24-hour survival and haemostasis versus a 1:1:2 ratio. The approach aims to treat trauma-induced coagulopathy proactively rather than reactively.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.