The PROMMTT study challenged traditional resuscitation ratios in massive haemorrhage. Which ratio of plasma:packed red blood cells most closely matches modern massive transfusion protocol recommendations?
- A 1:4
- B 1:2
- C 1:1 ✓
- D 2:1
Correct answer: C. 1:1
Explanation
The PROMMTT and subsequent PROPPR trials established that a 1:1:1 ratio of plasma:platelets:packed red blood cells (haemostatic resuscitation) reduces mortality compared to ratios with more RBCs (e.g., 1:4 or 1:2). The 1:1 plasma:RBC ratio better mimics whole blood and prevents dilutional coagulopathy in massive transfusion. The older 1:4 ratio led to coagulopathy and worse outcomes.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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