June 11, 2026 · The journal of trauma and acute care surgery · DOI: 10.1097/TA.0000000000005093

Fresh frozen plasma-first approach is independently associated with improved survival in severely injured patients undergoing massive transfusion

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The authors aimed to determine whether a fresh frozen plasma (FFP)-first approach improves survival in severely injured patients undergoing massive transfusion compared to a packed red blood cell (PRBC)-first approach. Their analysis of over 50,000 patients revealed that the FFP-first strategy was associated with lower six-hour, 24-hour, and in-hospital mortality rates, suggesting a potential benefit of prioritizing FFP in trauma care. They conclude that while the survival advantage is modest, further prospective or randomized trials are needed to confirm these findings.

Allyson M Hynes, Riley J Westein, Tyler J Turner, Ryan D Conrardy, Kai Yang, Kelly A Boyle, Jeremy H Levin, Marc A de Moya

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