A 70 kg trauma patient receives 4 units of packed red blood cells (PRBCs), 4 units of fresh frozen plasma (FFP), and 1 apheresis platelet unit (equivalent to 5 pooled units). Which complication of massive transfusion is specifically prevented by this 1:1:1 ratio protocol?
- A Transfusion-related acute lung injury (TRALI)
- B Dilutional coagulopathy and microvascular bleeding ✓
- C Hyperkalaemia from stored blood
- D Hypothermia from unwarmed blood products
Correct answer: B. Dilutional coagulopathy and microvascular bleeding
Explanation
The 1:1:1 ratio of PRBC:FFP:platelets in massive transfusion protocols (MTP) replicates whole blood composition and prevents dilutional coagulopathy — the depletion of clotting factors and platelets from giving large volumes of PRBCs without replacement of hemostatic components. Early FFP and platelet co-administration reduces transfusion-associated coagulopathy, microvascular bleeding, and mortality. TRALI is a separate FFP/platelet complication (not specifically prevented by ratio), and hypothermia requires blood warmers independent of transfusion ratios.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.