A 32-year-old man sustains a gunshot wound to the abdomen and is in haemorrhagic shock. Massive transfusion protocol is activated. Based on the PROPPR trial, what is the recommended ratio of fresh frozen plasma to packed red blood cells to platelets in the initial resuscitation?

• A 2:1:1
• B 1:3:1
• C 1:2:1
• D 1:1:1 ✓

Explanation

The PROPPR trial demonstrated that a 1:1:1 ratio of plasma to platelets to red cells achieved more rapid haemostasis and reduced death from exsanguination at 24 hours compared with a 1:1:2 ratio. Current massive transfusion guidelines therefore recommend a balanced 1:1:1 ratio. D 1:3:1 ratio is too plasma-deficient and does not reflect modern damage control resuscitation principles.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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