In massive transfusion protocol (MTP), the current recommended ratio of packed red blood cells to fresh frozen plasma to platelets is:

• A 1:1:1 (PRBC:FFP:platelets) ✓
• B 4:2:1 (PRBC:FFP:platelets)
• C 3:1:0 (PRBC:FFP, no empiric platelets)
• D 2:1:1 (PRBC:FFP:platelets)

Explanation

The PROPPR (Pragmatic Randomized Optimal Platelet and Plasma Ratios) trial (2015) demonstrated that a 1:1:1 ratio of PRBC:FFP:platelets in massive transfusion resulted in better haemostasis, fewer deaths from haemorrhage at 24 hours, and improved survival compared to a 1:1:2 ratio. This balanced haemostatic resuscitation replaces the older practice of crystalloid-heavy resuscitation with late blood product administration. The 1:1:1 ratio is now the standard of care in most major trauma centres.

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.