Giving plasma at a 1:1 ratio with red cells in resuscitation: who might benefit?

: Injury is the most common cause of death in North Americans aged 1 to 45 and the most important cause of the loss of productive life for all Americans. Traumatic injury kills 93,000 people in the United States each year with about half dying before they reach the hospital. Profound neurologic injury is the most common cause of death in trauma centers and uncontrolled hemorrhage is the second, but for patients who reach the hospital alive and subsequently die, uncontrolled hemorrhage is the most common cause of potentially preventable death. Thus, about 20,000 people die in the hospital of uncontrolled hemorrhage each year in the United States and the best estimate is that 3000 to 4000 of these deaths, 15 to 20 percent, are potentially preventable. These patients are typically massively transfused and coagulopathic, and control of their coagulopathy appears to be critical in saving them.