In massive transfusion protocol (MTP), the current evidence-based ratio of packed red blood cells : fresh frozen plasma : platelets is approximately:

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

Explanation

The PROPPR trial (2015) demonstrated that a 1:1:1 ratio (PRBC:FFP:platelets) reduced 24-hour and 30-day mortality compared to 1:1:2 in massive haemorrhage. This haemostatic resuscitation approach mirrors whole blood composition and prevents dilutional coagulopathy. TXA, fibrinogen concentrate (if fibrinogen <1.5 g/L), and calcium supplementation are administered adjunctively. Most MTP protocols are now built around 1:1:1.

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.