A woman develops massive obstetric hemorrhage requiring massive transfusion protocol. The OPTIMAL ratio of packed red blood cells to fresh frozen plasma to platelets in damage-control resuscitation is:

• A 4:1:1
• B 2:1:2
• C 6:4:1
• D 1:1:1 ✓

Explanation

Evidence from the PROPPR trial and obstetric hemorrhage protocols supports a 1:1:1 ratio of pRBC:FFP:platelets for massive transfusion, mimicking whole blood and preventing coagulopathy of dilution. This balanced resuscitation strategy reduces mortality compared to PRBC-predominant transfusion. The ratio reflects the goal of replacing all blood components proportionally during hemorrhage of this severity.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.