emDocs - January 14, 2014 - By Zach Radwine
"Resuscitation with crystalloid and plasma-poor red blood cell concentrates can lead to dilutional coagulopathy, which is further exacerbated by hypothermia, acidosis, and massive tissue injurythat accompany trauma and large-volume resuscitation.
Since the shift from whole blood to blood components in the 1980s there has been ongoing controversy regarding the ratio of components that should be given during massive transfusion (MT) in order to treat/prevent this coagulopathy. Recent evidence has suggested, largely in military setting, that a 1:1:1 ratio should be the goal.
Here we examine the evidence for the optimal ratio of plasma to platelets to red blood cells in massive transfusion."