Regarding massive transfusion protocol (MTP) in damage control resuscitation, the recommended ratio of packed red blood cells (pRBC): fresh frozen plasma (FFP): platelets is:

• A 1:1:1 (pRBC:FFP:platelets) ✓
• B 3:1:1 (pRBC:FFP:platelets)
• C 1:2:1 (pRBC:FFP:platelets)
• D 2:1:0 (no platelets until count <50,000)

Explanation

The PROPPR trial (2015) established that a 1:1:1 ratio of pRBC:FFP:platelets achieves better hemostasis, higher rates of 24-hour hemostasis, and improved 24-hour survival compared to a 2:1:1 ratio in patients with severe hemorrhagic shock requiring massive transfusion. This 'balanced resuscitation' approach mimics whole blood and prevents dilutional coagulopathy. Goal-directed therapy using TEG/ROTEM is increasingly used to individualize component therapy. Platelet transfusion is maintained to keep platelets >50,000 (or >100,000 if TBI).

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.