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Meta-Analysis
. 2025 Apr 24;4(4):CD012635.
doi: 10.1002/14651858.CD012635.pub2.

Blood transfusion strategies for major bleeding in trauma

Susan J Brunskill  1   2 , Arthur Disegna  3 , Henna Wong  4 , Jeremy Fabes  5   6   7 , Michael Jr Desborough  8   9 , Carolyn Dorée  1   2 , Ross Davenport  10 , Nicola Curry  9   11 , Simon J Stanworth  8   9
Affiliations
Meta-Analysis

Blood transfusion strategies for major bleeding in trauma

Susan J Brunskill et al. Cochrane Database Syst Rev. .

Abstract

Background: Trauma is a leading cause of morbidity and mortality worldwide. Research shows that haemorrhage and trauma-induced coagulopathy are reversible components of traumatic injury, if identified and treated early. Lack of consensus on definitions and transfusion strategies hinders the translation of this evidence into clinical practice.

Objectives: To assess the beneficial and harmful effects of transfusion strategies started within 24 hours of traumatic injury in adults (aged 16 years and over) with major bleeding.

Search methods: CENTRAL, MEDLINE, Embase, five other databases, and three trial registers were searched on 20 November 2023. We also checked reference lists of included studies to identify any additional studies.

Selection criteria: We included randomised controlled trials (RCTs) of adults (aged 16 years and over) receiving blood products for the management of bleeding within 24 hours of traumatic injury.

Data collection and analysis: We used standard Cochrane methodology to perform the review and assessed the certainty of the evidence using GRADE.

Main results: We included 18 RCTs with 5041 participants. Comparison 1: Prehospital transfusion strategies Five studies compared use of plasma (fresh frozen plasma (FFP) or lyophilised plasma) versus 'standard of care'. We are uncertain of the effect of plasma on all-cause mortality at 24 hours (risk ratio (RR) 1.05, 95% confidence interval (CI), 0.48 to 2.30; 3 studies, 279 participants; very low certainty evidence). There is probably no difference between plasma and standard of care in all-cause mortality at 30 days (RR 0.95, 95% CI 0.78 to 1.17; 3 studies, 664 participants; moderate-certainty evidence). However, the results of one cluster-RCT that could not be included in our meta-analysis suggested that plasma may be associated with a lower risk of death at 30 days (RR 0.54, 95% CI 0.42 to 0.70; 1 study, 481 participants; low-certainty evidence). There may be no difference between plasma and standard of care in the total number of thromboembolic events in 30 days (RR 1.23, 95% CI 0.67 to.2.27; 4 studies, 586 participants; low-certainty evidence). Comparison 2: In-hospital transfusion strategies Ten studies evaluated this comparison, seven providing usable data. The studies evaluated cryoprecitate (three studies); fixed-ratio blood component transfusion (three studies); fresh frozen plasma (FFP) (one study); lyophilised plasma (one study); leucoreduced red blood cells (one study); and a restrictive transfusion strategy (one study). All-cause mortality at 24 hours For all-cause mortality at 24 hours, there is probably no difference between: • cryoprecipitate plus a major haemorrhage protocol (MHP) versus MHP alone (RR 0.92, 95% CI 0.70 to 1.21; 1 study, 1577 participants; moderate-certainty evidence); and • blood products (plasma:platelets:red blood cells (RBCs)) transfused in 1:1:1 ratio versus 1:1:2 ratio (RR 0.75, 95% CI 0.52 to 1.08; 1 study, 680 participants; moderate-certainty evidence). We are uncertain of the effect on all-cause mortality at 24 hours for: • blood products (RBCs:FFP) transfused in 1:1 ratio versus transfusion according to coagulation and full blood count results (Peto odds ratio (POR) 0.45, 0.17 to 1.22; 1 study, 434 participants; very low certainty evidence); and • lyophilised (FlyP) plasma versus FFP (POR 1.04, 95% CI 0.06 to 17.23; 1 study, 47 participants; very low certainty evidence); All-cause mortality at 30 days For all-cause mortality at 30 days, there is probably no difference between blood products (plasma:platelets:RBCs) transfused in a 1:1:1 ratio versus a 1:1:2 ratio (RR 0.85, 95% CI 0.65 to 1.11; 1 study, 680 participants; moderate-certainty evidence). There may be little to no difference between the following interventions in all-cause mortality at 30 days: • cryoprecipitate plus MHP versus MHP alone (RR 0.77, 95% CI 0.33 to 1.78; 2 studies, 1572 participants; low-certainty evidence); and •leucoreduced RBCs versus standard RBCs (RR 1.20, 95% CI 0.74 to 1.95; 1 study,55 participants; low certainty evidence). We are uncertain of the effect on all-cause mortality at 30 days for: •lyophilised plasma versus FFP (RR 0.75, 95% CI 0.28 to 2.02; 1 study, 47 participants; very low certainty evidence); and • blood products (plasma:platelets:RBCs) transfused in 1:1:1 ratio versus standard MHP (RR 2.25, 95% CI 0.90 to 5.62; 1 study, 69 participants; very low certainty evidence). Total number of thromboembolic events at 30 days There may be little to no difference between the following interventions for total thromboembolic events at 30 days: • cryoprecipitate plus MHP versus MHP alone (RR 0.55, 95% CI 0.08 to 3.72; 2 studies, 1645 participants; low-certainty evidence); and • blood products (plasma:platelets:RBCs) transfused in 1:1:1 ratio versus 1:1:2 ratio (RR 1.03, 95% CI 0.75 to 1.42; 1 study, 680 participants; low-certainty evidence). We are uncertain of the effect on the total number of thromboembolic events at 30 days for: •blood products (plasma:platelets:RBCs) transfused in 1:1:1 ratio versus standard MHP (POR 6.83, 95% CI 0.68 to 68.35; 1 study, 69 participants; very low certainty evidence). Comparison 3: Whole blood versus individual blood products We are uncertain of the effect of modified (leucoreduced) whole blood versus blood products (RBCs:plasma) transfused in a 1:1 ratio on all-cause mortality at 24 hours (RR 1.13, 95% CI 0.37 to 3.49) or 30 days (RR 1.62, 95% CI 0.69 to 3.80) (1 study, 107 participants; very low certainty evidence). Comparison 4: Goal-directed blood transfusion strategy of viscoelastic haemostatic assay (VHA) versus conventional laboratory coagulation tests (CCT) to guide haemostatic therapy There may be little or no difference in all-cause mortality at 24 hours between VHA and CCT (RR 0.85, 95% CI 0.54 to 1.35; 1 study, 396 participants; low-certainty evidence). We are uncertain of the effects on all-cause mortality at 30 days (RR 0.75, 95% CI 0.48 to 1.17; 2 studies, 506 participants; very low certainty evidence). There is probably no difference between VHA and CCT in total thromboembolic events at 30 days (RR 0.65, 95% CI 0.35 to 1.18; 1 study 396 participants; moderate-certainty evidence).

Authors' conclusions: Overall, there was little to no evidence of a difference between blood transfusion strategies for mortality or thromboembolic events. The studies covered a wide range of interventions, and the comparators and standard of care practice varied between trials, thereby limiting the pooling of data. Further research is needed.

Trial registration: ClinicalTrials.gov NCT02736812 NCT02416817 NCT04431999 NCT04684719 NCT04726410.

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Conflict of interest statement

SJB: none AD: none HW: none JF: none MJRD: none CD: none RD was involved in two of the included studies (Baksaas‐Aasen 2021; Curry 2015). In Baksaas‐Aasen 2021, RD contributed to the study design, development, and set up, site set up, participantt enrolment, data collection, and research governance. In Curry 2015, RD revised the manuscript. RD was not involved in the data extraction of Baksaas‐Aasen 2021 or Curry 2015 for this review. RD is a co‐investigator of an ongoing study (Davenport 2023). NC was involved in two of the included studies (Baksaas‐Aasen 2021; Curry 2015). In Baksaas‐Aasen 2021, NC contributed to the study design, development, and set up, site set up, participant enrolment, data collection, and research governance. In Curry 2015, NC contributed to the study design, patient recruitment, study conduct, data collection, data analysis, and writing the paper. NC was not involved in the data extraction of Baksaas‐Aasen 2021 or Curry 2015 for this review. NC is a co‐investigator of an ongoing study (Davenport 2023). SJS was involved in two of the included studies (Baksaas‐Aasen 2021; Curry 2015). In Baksaas‐Aasen 2021, SJS contributed to the study design, development, and set up, site set up, participant enrolment, data collection, and research governance. In Curry 2015, SJS contributed to the study design, conduct, and oversight, data analysis, and critical review of the paper. SJS was not involved in the data extraction or analysis of any data in this review. SJS is the chief investigator of an ongoing study (Davenport 2023).

Update of

  • doi: 10.1002/14651858.CD012635

References

References to studies included in this review

Baksaas‐Aasen 2021 {published data only}
    1. Baksaas-Aasen K, Gall LS, Stensballe J, Juffermans NP, Curry N, Maegele M, et al. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. Intensive Care Medicine 2021;47(1):49-59. - PMC - PubMed
    1. NCT02593877. Implementing treatment algorithms for the correction of trauma induced coagulopathy [A multi-centre, prospective, randomized controlled study to compare outcomes of viscoelastic haemostatic assay (VHA)-guided resuscitation versus conventional resuscitation support in haemorrhaging trauma patients]. https://clinicaltrials.gov/ct2/show/NCT02593877 (first received 15 October 2015).
    1. Vigstedt M, Baksaas-Aasen K, Henriksen HH, Maegele M, Stanworth S, Juffermans NP, et al. Thrombelastography (TEG® 6s) early amplitudes predict maximum amplitude in severely injured trauma patients. Scandinavian Journal of Clinical and Laboratory Investigation 2022;82(6):508-12. - PubMed
Cotton 2013 {published data only}
    1. Anonymous. Erratum: a randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions. Annals of Surgery 2014;260(1):178. - PubMed
    1. Cotton BA, Podbielski J, Camp E, Welch T, Del Junco D, Bai Y, et al. A randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions. [Erratum appears in Annals of Surgery 2014 Jul;260(1):178]. Annals of Surgery 2013;258(4):527-32; discussion 532-3. - PubMed
    1. NCT01227005. Early whole blood in patients requiring transfusion after major trauma. https://clinicaltrials.gov/ct2/show/NCT01227005 (first received 20 October 2010).
Crombie 2022 {published data only}62326938
    1. Crombie N, Doughty HA, Bishop JRB, Desai A, Dixon EF, Hancox JM, et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, controlled, phase 3 trial. Lancet Haematology 2022;9(4):e250-61. [DOI: 10.1016/S2352-3026(22)00040-0] - DOI - PMC - PubMed
    1. EUCTR2015‐001401‐13‐GB. A multi-centre randomised controlled trial of pre-hospital administration of packed red blood cells and freeze-dried plasma to patients with low blood pressure after major injuries. https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01832501/... 2019.
    1. ISRCTN62326938. A study comparing pre-hospital administration of packed red blood cells and freeze-dried plasma with administration of normal saline in patients with low blood pressure after major injuries [A multi­centre randomised controlled trial of pre­hospital blood product administration versus standard care for traumatic haemorrhage]. https://www.isrctn.com/ISRCTN62326938 (first received 11 July 2016).
Curry 2015 {published data only}
    1. Curry N, Rourke C, Davenport R, Beer S, Pankhurst L, Deary A, et al. Early cryoprecipitate for major haemorrhage in trauma: a randomised controlled feasibility trial. British Journal of Anaesthesia 2015;115(1):76-83. - PubMed
    1. ISRCTN55509212. CRYOSTAT study: to determine whether early administration of cryoprecipitate in bleeding trauma patients is possible [A feasibility study for a multi-centre, randomised controlled trial evaluating the effects of early administration of cryoprecipitate in major traumatic haemorrhage]. https://www.isrctn.com/ISRCTN55509212 (first received 12 September 2012).
Davenport 2023 {published data only}14998314
    1. Curry N, Davenport R, Lucas J, Deary A, Benger J, Edwards, A et al. The CRYOSTAT2 trial: the rationale and study protocol for a multi-centre, randomised, controlled trial evaluating the effects of early high-dose cryoprecipitate in adult patients with major trauma haemorrhage requiring major haemorrhage protocol activation. Transfusion Medicine 2023;33(2):123-31. - PubMed
    1. Davenport R, Curry N, Fox EE, Thomas H, Lucas J, Evans A et al. Early and empirical high-dose cryoprecipitate for hemorrhage after traumatic injury: the CRYOSTAT-2 randomized clinical trial. Journal of the American Medical Association 2023;330(19):1882-91. - PMC - PubMed
    1. ISRCTN14998314. Early cryoprecipitate in major trauma haemorrhage: CRYOSTAT-2 [CRYOSTAT-2: A multi-centre, randomised, controlled trial evaluating the effects of early high-dose cryoprecipitate in adult patients with major trauma haemorrhage requiring major haemorrhage protocol (MHP) activation]. https://www.isrctn.com/ISRCTN14998314 (first received 19 April 2017).
    1. NCT04704869. Early use of cryoprecipitate with major hemorrhage protocol (MHP) activation [A multi-center, randomized, controlled trial evaluating the effects of early high-dose cryoprecipitate in adult patients with major trauma hemorrhage requiring major hemorrhage protocol (MHP) activation]. https://clinicaltrials.gov/ct2/show/NCT04704869 (first received 12 January 2021).
Fan 2023 {published data only}
    1. Fan Y, Ye Z, Tang Y. Effect of early equal-proportional infusion of plasma and red blood cells on the prognosis of emergency patients with traumatic hemorrhage. Clincial Laboratory 2023;69:1407-13. - PubMed
Garrigue 2018 {published data only}
    1. Garrigue D, Godier A, Glacet A, Labreuche J, Kipnis E, Paris C, et al. French lyophilized plasma versus fresh frozen plasma for the initial management of trauma-induced coagulopathy: a randomized open-label trial. Journal of Thrombosis and Haemostatsis 2018;16(3):481-9. - PubMed
    1. NCT02750150. Freeze-dried plasma in the initial management of coagulopathy in trauma patients [A randomized trial to evaluate freezed-dried plasma in the initial management of coagulopathy in trauma patients]. https://clinicaltrials.gov/ct2/show/NCT02750150 (first received 5 April 2016).
Gonzalez 2016 {published data only}
    1. Gonzalez E, Moore EE, Moore HB, Chapman MP, Chin TL, Ghasabyan A, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Annals of Surgery 2016 ;263(6):1051-9. [DOI: 10.1097/SLA.0000000000001608 [doi]] - PMC - PubMed
    1. NCT01536496. Comparison of rapid thrombelastography and conventional coagulation testing for haemostatic resuscitation in trauma [A prospective, randomized comparison of rapid thrombelastography (r-TEG) and conventional coagulation testing for guiding the diagnosis and haemostatic resuscitation of trauma patients at risk for post-injury coagulopathy]. https://clinicaltrials.gov/ct2/show/NCT01536496 (first received 19 July 2012).
Hayakawa 2023 {published data only}000034405
    1. Hayakawa M, Tagami T, Kudo D, Ono K, Aoki M, Endo A, et al. The restrictive red blood cell transfusion strategy for critically injured patients (RESTRIC) trial: a cluster-randomized, crossover, non-inferiority multicenter trial of restrictive transfusion in trauma. Journal of Intensive Care 2023;11(1):34. - PMC - PubMed
    1. Hayakawa M, Tagami THO, Ijima Kudo D, Sekine K, Ogura T, Yumoto, T et al. Restrictive transfusion strategy for critically injured patients (RESTRIC) trial: a study protocol for a cluster-randomised, crossover non-inferiority trial. BMJ Open 2020;10(9):e037238. - PMC - PubMed
    1. Hayakawa M. Restrictive transfusion strategy for critically injured patients trial. https://rctportal.niph.go.jp/en/detail?trial_id=UMIN000034405 (first received 10 October 2018). - PMC - PubMed
    1. UMIN000034405. Restrictive transfusion strategy for critically injured patients trial. https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01946742/ (first added 31 July 2019).
Holcomb 2015 {published data only}
    1. Abraham P, Baird E, Griffin R, Kerby JD, Jansen JO, Holcomb JB. Predicting need for transfusion: diagnostic performance of the ABC score in the PROPPR trial. Journal of the American College of Surgeons 2023;236(5):S128.
    1. Abraham PJ, Gonzalez-Sigler I, Reynolds L, Griffin R L, Gelbard RB, Kerby JD et al. Balancing enrollment and mortality in hemorrhage control trials: a secondary analysis of the PROPPR trial. Journal of Trauma and Acute Care Surgery 2022;92(6):1054-60. - PubMed
    1. Baraniuk S, Tilley BC, Del Junco DJ, Fox EE, Van Belle G, Wade CE, et al. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial: design, rationale and implementation. Injury 2014;45(9):1287-95. - PMC - PubMed
    1. Callcut RA, Simpson KN, Baraniuk S, Fox EE, Tilley BC, Holcomb JB, Group PROPPR Study. Cost-effectiveness evaluation of the PROPPR trial transfusion protocols. Transfusion 2020;60(5):922-31. - PMC - PubMed
    1. Chang R, Kerby JD, Kalkwarf KJ, Van Belle G, Fox EE, Cotton BA, et al. Earlier time to hemostasis is associated with decreased mortality and rate of complications: results from the Pragmatic Randomized Optimal Platelet and Plasma Ratio trial. Journal of Trauma and Acute Care Surgery 2019;87(2):342-9. - PMC - PubMed
Jost 2022 {published data only}
    1. Jost D, Lemoine S, Lemoine F, Derkenne C, Beaume S, Lanoe V, et al. Prehospital lyophilized plasma transfusion for trauma-induced coagulopathy in patients at risk for hemorrhagic shock: a randomized clinical trial. JAMA Network Open 2022;5(7):e2223619. - PMC - PubMed
    1. Jost D, Lemoine S, Lemoine F, Lanoe V, Maurin O, Derkenne C, et al. French lyophilized plasma versus normal saline for post-traumatic coagulopathy prevention and correction: PREHO-PLYO protocol for a multicenter randomized controlled clinical trial. Trials 2020;21(1):106. - PMC - PubMed
    1. NCT02736812. Pre-hospital administration of lyophilized plasma for post-traumatic coagulopathy treatment (PREHO-PLYO) [Interest of pre-hospital administration of lyophilized plasma to prevent or treat coagulopathy associated with post-traumatic hemorrhagic shock (PREHO-PLYO Study )]. https://clinicaltrials.gov/ct2/show/NCT02736812 (first received 13 April 2016).
Mitra 2023 {published data only}
    1. ACTRN12622000763741. Pre-hospital freeze-dried plasma for critical bleeding after trauma among adult patients receiving blood transfusion: a pilot trial. https://anzctr.org.au/ (first received 27 May 2022).
    1. Mitra B, Meadley B, Bernard S, Maegele M, Gruen RL, Bradley O, et al. Pre-hospital freeze-dried plasma for critical bleeding after trauma: a pilot randomized controlled trial. Academic Emergency Medicine 2023;30(10):1013-9. - PMC - PubMed
Moore 2018 {published data only}
    1. Chapman MP, Moore EE, Chin TL, Ghasabyan A, Chandler J, Stringham J, et al. Combat: Initial experience with a randomized clinical trial of plasma-based resuscitation in the field for traumatic hemorrhagic shock. Shock 2015;44:63-70. - PMC - PubMed
    1. Moore EE, Moore HB, Chapman MP, Sauaia A. Prehospital plasma resuscitation of hemorrhagic shock in an urban ground ambulance transport system does not improve survival: a pragmatic, randomized trial. Shock 2019;51(6 Supplement 1):26-7.
    1. Moore HB, Moore EE, Chapman MP, McVaney K, Bryskiewicz G, Blechar R, et al. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet 2018;392(10144):283-91. - PMC - PubMed
    1. NCT01838863. Control of major bleeding after trauma study [A prospective, randomized comparison of fresh frozen plasma versus standard crystalloid intravenous fluid as initial resuscitation fluid]. https://clinicaltrials.gov/ct2/show/NCT01838863 (first received 22 April 2013).
Nascimento 2013 {published data only}
    1. Curry N. Query over “deaths due to exsanguination timepoint” in Nascimento 2013. Email to: J Callum 3 May 2022.
    1. NCT00945542. The trauma-formula-driven versus lab-guided study (TRFL Study) [Formula-driven vs laboratory-guided transfusion practices in bleeding trauma patients: a feasibility randomized controlled study]. https://clinicaltrials.gov/ct2/show/NCT00945542 (first received 22 July 2009).
    1. Nascimento B, Callum J, Tien H, Rubenfeld G, Pinto R, Lin Y, et al. Effect of a fixed-ratio (1:1:1) transfusion protocol versus laboratory-results-guided transfusion in patients with severe trauma: a randomized feasibility trial. CMAJ Canadian Medical Association Journal 2013;185(12):E583-9. - PMC - PubMed
    1. Nascimento B, Rizoli S, Rubenfeld G, Lin Y, Callum J, Tien H. Design and preliminary results of a pilot randomized controlled trial on a 1:1:1 transfusion strategy: the trauma formula-driven versus laboratory-guided study. Journal of Trauma 2011;71(5 Suppl 1):S418-26. - PubMed
    1. Rizoli S, Nascimento B, Tien H, Lin YL, Callum J. The trauma formula-driven versus laboratory-guided study: challenges andL lessons in desigining a massive transfusion randomized control trial in Trauma. In: Circulation. Vol. 122. 2010:2225, HT3-303.
Nathens 2006 {published data only}
    1. NCT00135291. Effect of leukoreduced blood transfusions on infection following trauma [Effect of leukoreduction in infection risk in trauma]. https://clinicaltrials.gov/study/NCT00135291 (first received 23 August 2005).
    1. Nathens AB, Nester TA, Rubenfeld GD, Nirula R, Gernsheimer TB. The effects of leukoreduced blood transfusion on infection risk following injury: a randomized controlled trial. Shock 2006;26(4):342-7. - PubMed
Saeidiborojeni 2022 {published data only}20190729044375N
    1. IRCT20190729044375N1. Effect of cryopercipitate in trauma patients with brain contusion [Clinical trial to compare the effect of cryopericiptate and conventional treatment on prevention of brain contusion expansion in trauma patients]. https://irct.behdasht.gov.ir/trial/41201 (first received 31 January 2021).
    1. Saeidiborojeni H, Tahmoures A, Naderi M, Akrami MR. The effect of cryoprecipitate on prevention of intra cerebral hemorrhage and brain contusion expansion in traumatic patients. Journal of Injury & Violence Research 2022;14(3):183-9. - PMC - PubMed
Sperry 2018 {published data only}
    1. Anto VP, Guyette FX, Brown J, Daley B, Miller R, Harbrecht B, et al. Severity of hemorrhage and the survival benefit associated with plasma: results from a randomized prehospital plasma trial. Journal of Trauma and Acute Care Surgery 2020;88(1):141-47. - PubMed
    1. Brown JB, Guyette FX, Neal MD, Claridge JA, Daley BJ, Harbrecht BG, et al. Taking the blood bank to the field: the design and rationale of the Prehospital Air Medical Plasma (PAMPer) trial. Prehospital Emergency Care 2015;19(3):343-50. - PMC - PubMed
    1. Campwala I, Guyette FX, Brown JB, Adams PW, Early BJ, Yazer MH, et al. Patient and surrogate attitudes via an interviewer-administered survey on exception from informed consent enrolment in the Prehospital Air Medical Plasma (PAMPer) trial. BMC Emergency Medicine 2020;20:76. - PMC - PubMed
    1. Gruen DS, Guyette FX, Brown JB, Daley BJ, Miller RS, Harbrecht BG, et al. Characterization of unexpected survivors following a prehospital plasma randomized trial. Journal of Trauma and Acute Care Surgery 2020;89(5):908-14. - PMC - PubMed
    1. Gruen DS, Guyette FX, Brown JB, Okonkwo DO, Puccio AM, Campwala IK, et al. Association of prehospital plasma with survival in patients with traumatic brain injury: a secondary analysis of the PAMPer cluster randomized clinical trial. JAMA Network Open 2020;3(10):e2016869. - PMC - PubMed
Zhang 2019 {published data only}
    1. Zhang LM, Li R, Sun WB, Wang XP, Qi MM, Bai Y, et al. Low-dose, early fresh frozen plasma transfusion therapy after severe trauma brain injury: a clinical, prospective, randomized, controlled study. World Neurosurgery 2019;132:e21-7. - PubMed

References to studies excluded from this review

ChiCTR2100045044 {published and unpublished data}
    1. ChiCTR2100045044. Observation on the effectiveness and safety of sodium bicarbonate Ringer's solution in the early resuscitation of traumatic hemorrhagic shock: a clinical single-center prospective randomized controlled trial. https://www.chictr.org.cn/showproj.html?proj=124588 (first received 4 April 2021). - PMC - PubMed
DaLuz 2022 {published data only}
    1. Da Luz L, Callum J, Beckett A, Peng H, Engels P, Parry N, et al. FiiRST-2; a prospective, randomized study of clotting factor concentrates versus standard massive hemorrhage protocol in severely bleeding trauma patients. In: Research and Practice in Thrombosis and Haemostasis. Vol. 6. 2022:(Supplement 1).
Gerard 2023 {published data only}
    1. Gerard J, Mueck K, Lubkin D, Hatton G, Brill J, Boukas K, et al. An assessment of the safety, hemostatic efficacy, and clinical impact of low-titer group O whole blood in children and adolescents. Journal of Trauma and Acute Care Surgery 2023;95(4):497-502. - PubMed
IRCT20150704023046N4 {published data only}
    1. IRCT20150704023046N4. Effect of fibrinogen compared to fresh frozen plasma on patients with hemorrhagic shock [Comparison of the fibrinogen and fresh frozen plasma efficacy in patients outcome with hemorrhagic shock due to multiple trauma]. https://www.irct.ir/trial/35729 (first received 8 February 2020).
NCT02416817 {published data only}
    1. NCT02416817. Strategy of Transfusion in Trauma Patients - STATA Trial [Clinical trial: evaluation of 2 different protocols of blood derivates transfusion in acute trauma patients in a Brazilian tertiary hospital]. https://clinicaltrials.gov/ct2/show/NCT02416817 (first received 28 August 2014).
NCT03380767 {published data only}
    1. NCT03380767. Use of viscoelastic tests in the treatment of traumatic induced coagulopathy: a pragmatic randomized clinical trial. https://clinicaltrials.gov/show/NCT03380767 (first received 17 December 2017).
NCT03477006 {published data only}
    1. NCT03477006. Pragmatic prehospital group O whole blood early resuscitation trial [Pragmatic prehospital group O whole blood early resuscitation (PPOWER) trial: a prospective, interventional, randomized, 3 year, pilot clinical trial]. https://clinicaltrials.gov/ct2/show/NCT03477006 (first received 19 March 2018).
NCT04149171 {published data only}
    1. NCT04149171. Transfusion of red blood cells, tranexamic acid and fibrinogen concentrate for severe trauma hemorrhage [Transfusion of red blood cells, tranexamic acid and fibrinogen concentrate for severe trauma hemorrhage at pre-hospital phase of care. a pilot trial]. https://clinicaltrials.gov/ct2/show/NCT04149171 (first received 26 February 2019).
NCT04866953 {published data only}
    1. NCT04866953. UltraMTP in adult trauma patients undergoing surgery within 24 hours: effects on mortality and clinical outcomes [At what point is blood transfusion futile in trauma?: a retrospective study of ultra massive transfusion protocol in adult trauma patients undergoing surgery within 24 hours and effects on mortality and clinical outcomes]. https://clinicaltrials.gov/ct2/show/NCT04866953 (first received August 2021).
Reed 1986 {published data only}
    1. Reed II RL, Ciavarella D, Heimbach DM. Prophylactic platelet administration during massive transfusion: a prospective, randomized, double-blind clinical study. Annals of Surgery 1986;203(1):40-8. - PMC - PubMed
Reynolds 2015 {published data only}
    1. NCT02303964. Pre-Hospital Use of Plasma for Traumatic Hemorrhage (PUPTH) [Pre-Hospital Use of Plasma for Traumatic Hemorrhage]. https://clinicaltrials.gov/ct2/show/NCT02303964 (first received 6 October 2014).
    1. Reynolds PS, Michael MJ, Cochran ED, Wegelin JA, Spiess BD. Prehospital use of plasma in traumatic hemorrhage (the PUPTH Trial): study protocol for a randomised controlled trial. Trials 2015;16:321. - PMC - PubMed
Richards 2021 {published data only}
    1. Richards JE, Jackson BP. Whole blood for trauma patients: outcomes at higher doses. Transfusion 2021;61(6):1661-4. - PubMed
Schreiber 2015 {published data only}
    1. Schreiber MA, McCully BH, Holcomb JB, Robinson BR, Minei JP, Stewart R et al. Transfusion of cryopreserved packed red blood cells is safe and effective after trauma: a prospective randomized trial. Annals of Surgery 2015;262(3):426-33. - PubMed
Sperry 2019 {published data only}
    1. Sperry J, Guyette F. The prehospital air medical plasma (pamper) trial: Implications for traumatic injury. Shock 2019;51(6 Supplement 1):27.
Tolles 2022 {published data only}
    1. Tolles J, Beiling M, Schreiber MA, Del Junco DJ, McMullan JT, Guyette FX et al. An adaptive platform trial for evaluating treatments in patients with life-threatening hemorrhage from traumatic injuries: rationale and proposal. Transfusion 2022;62(S1):S231-41. - PubMed
Watkins 2008 {published data only}
    1. Watkins TR, Rubenfeld GD, Martin TR, Nester TA, Caldwell E, Billgren J, et al. Effects of leukoreduced blood on acute lung injury after trauma: a randomized controlled trial. Critical Care Medicine 2008;36(5):1493-9. - PubMed

References to studies awaiting assessment

Akbari 2018 {published data only}
    1. Akbari E, Safari S, Hatamabadi H. The effect of fibrinogen concentrate and fresh frozen plasma on the outcome of patients with acute traumatic coagulopathy: a quasi-experimental study. American Journal of Emergency Medicine 2018;36(11):1947-50. - PubMed
Guyette 2023 {published data only}
    1. Guyette FX, Zenati M, Triulzi DJ, Yazer MH, Skroczky H, Early B, et al. Prehospital low titer group O whole blood is feasible and safe: results of a prospective randomized pilot trial. Journal of Trauma and Acute Care Surgery 2022;92(5):839-47. - PMC - PubMed
NCT03765866 {published data only}
    1. NCT03765866. Rotational Thromboelastometry Activated Transfusion In Trauma Trial (ROTATE-IT) [Viscoelastic guided goal directed resuscitation of severely injured patients]. https://clinicaltrials.gov/ct2/show/NCT03765866 (first received 23 May 2018).
NCT05081063 {published data only}
    1. NCT05081063. Low-titer O positive whole blood versus component therapy for emergent transfusion in trauma patients. https://clinicaltrials.gov/ct2/show/NCT05081063 (first received 18 October 2021).
NCT05502809 {published data only}
    1. NCT05502809. Frozen platelets in the treatment of traumatic or vascular bleeding (MAFOD) [The haemostatic effect of deep-frozen platelets versus room temperature stored platelets in the treatment of traumatic or vascular bleeding. MAFOD: a randomized controlled non-inferiority trial]. https://classic.clinicaltrials.gov/ct2/show/NCT05502809 (first received 16 August 2022). - PMC - PubMed

References to ongoing studies

ChiCTR2100054578 {published data only}
    1. ChiCTR2100054578. TEG-guided coagulation management for patients with traumatic brain injury complicated with coagulation dysfunction [TEG-guided coagulation management for patients with traumatic brain injury complicated with coagulation dysfunction]. https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2100054578 (first received 24 October 2019).
ChiCTR‐ICR‐15006073  {published data only}
    1. ChiCTR-ICR-15006073. Application of rapid thromboelastometry in target-directed blood transfusion in patients with severe trauma [Application of rapid thromboelastometry in target-directed blood transfusion in patients with severe trauma]. https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR%E2%80%90ICR%E2%80... (first received in 2015).
CTRI/2022/04/042334 {published data only}
    1. CTRI/2022/04/042334. Bedside clotting study (thromboelastography) for critical decision making in patients requiring massive blood transfusion at trauma centre [Point of care thromboelastography for critical decision making in patients requiring massive transfusion protocol at level 1 trauma centre]. https://trialsearch.who.int/Trial2.aspx?TrialID=CTRI/2022/04/042334 (first received 19 April 2022).
NCT04431999 {published data only}
    1. Martinaud C, Tiberghien P, Begue S, Sailliol A, Gross S, Pouget T, et al. Rational and design of the T-STORHM Study: a prospective randomized trial comparing fresh whole blood to blood components for acutely bleeding trauma patients. Transfusion Clinique et Biologique 2019;26(426):198-201. - PubMed
    1. NCT04431999. Evaluation of a transfusion therapy using whole blood in the management of coagulopathy in patients with acute traumatic hemorrhage (T-STORHM) [Evaluation of a transfusion therapy using whole blood versus fractionated blood products in the management of coagulopathy in patients admitted to hospital for acute traumatic hemorrhage]. https://clinicaltrials.gov/ct2/show/NCT04431999 (first received 16 June 2020).
NCT04684719 {published data only}
    1. NCT04684719. Type O whole blood and assessment of age during prehospital resuscitation trial [Type O whole blood and assessment of age during prehospital resuscitation (TOWAR) trial]. https://clinicaltrials.gov/ct2/show/NCT04684719 (first received 24 December 2020).
NCT04726410 {published data only}
    1. NCT04726410. Cold-stored platelet early intervention in TBI (CriSP-TBI) [Cold stored platelet early intervention in traumatic brain injury trial]. https://clinicaltrials.gov/ct2/show/NCT04726410 (first received 27 January 2021).
NCT04879485 {published data only}
    1. NCT04879485. Prehospital transfusion strategy in bleeding patients [Prehospital plasma or red blood cell transfusion strategy in major bleeding; PRIEST trial]. https://clinicaltrials.gov/show/NCT04879485 (first received 10 May 2021).
NCT05634109 {published data only}
    1. NCT05634109. Whole blood in trauma patients with hemorrhagic shock (WEBSTER) [Whole blood vs. blood components therapy in the hemostatic resuscitation of severe trauma patients: an open-label, randomized, controlled clinical trial]. https://clinicaltrials.gov/study/NCT05634109 (first received 16 November 2022).
NCT06062888 {published data only}
    1. NCT06062888. FFP In Traumatic BRAin INjury (FIT-BRAIN) Trial [Multi-institutional phase 2/3 trial of fresh frozen plasma (FFP) in patients with moderate to severe traumatic brain injury (TBI)]. https://classic.clinicaltrials.gov/ct2/show/NCT06062888 (first received 13 September 2023).
NCT06070350 {published data only}
    1. NCT06070350. Massive transfusion in children-2: a trial examining life threatening hemorrhage in children (MATIC-2). https://clinicaltrials.gov/study/NCT06070350 (first received 27 September 2023).
Smith 2023 {published data only}
    1. ISRCTN23657907. Study of whole blood in frontline trauma [A multi-centre randomised controlled trial of the clinical and cost-effectiveness of pre-hospital whole blood administration versus standard care for traumatic haemorrhage]. https://www.isrctn.com/ISRCTN23657907 (first received 18 November 2022). - PMC - PubMed
    1. Smith JE, Barnard EBG, Brown-O'Sullivan C, Cardigan R, Davies J, Hawton, A et al. The SWiFT trial (Study of Whole Blood in Frontline Trauma)-the clinical and cost effectiveness of pre-hospital whole blood versus standard care in patients with life-threatening traumatic haemorrhage: study protocol for a multi-centre randomised controlled trial. Trials 2023;24(1):725. - PMC - PubMed

Additional references

Abuelazm 2024
    1. Abuelazm M, Rezq H, Mahmoud A, Tanashat M, Salah A, Saleh O, et al. The efficacy and safety of pre-hospital plasma in patients at risk for hemorrhagic shock: an updated systematic review and meta-analysis of randomized controlled trials. European Journal of Trauma and Emergency Surgery 2024;17:1-11. [DOI: 10.1007/s00068-024-02461-7] - DOI - PMC - PubMed
Brohi 2003
    1. Brohi K, Singh J, Heron M, Coats T. Acute traumatic coagulopathy. Journal of Trauma: Injury, Infection, and Critical Care 2003;54(6):1127-30. [DOI: 10.1097/01.TA.0000069184.82147.06] - DOI - PubMed
Brohi 2019
    1. Brohi K, Gruen RL, Holcomb JB. Why are bleeding trauma patients still dying? Intensive Care Medicine 2019;45(5):709-11. - PubMed
Cohen 2012
    1. Cohen MJ, Call M, Nelson M, Calfee CS, Esmon CT, Brohi K, et al. Critical role of activated protein C in early coagulopathy and later organ failure, infection and death in trauma patients. Annals of Surgery 2012;255(2):379–85. [DOI: 10.1097/SLA.0b013e318235d9e6] - DOI - PMC - PubMed
Coulthard 2024
    1. Coulthard SL, Kaplan LJ, Cannon JW. What's new in whole blood resuscitation? In the trauma bay and beyond. Current Opinion in Critical Care 2024;30(3):209-16. - PubMed
Covidence 2023 [Computer program]
    1. Covidence. Version accessed prior to 6 March 2025. Melbourne, Australia: Veritas Health Innovation, 2023. Available at https://www.covidence.org.
CRASH‐2 2010
    1. CRASH-2 trial collaborators. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet 2010;376(9734):23–32. [DOI: 10.1016/S0140-6736(10)60835-5] - DOI - PubMed
Davenport 2023
    1. Davenport R, Curry N, Fox EE, Thomas H, Lucas J, Evans A, et al. Early and empirical high-dose cryoprecipitate for haemorrhage after traumatic injury: the CRYOSTAT-2 randomised clinical trial. Journal of the American Medical Association 2023;330(19):1882-91. [DOI: 10.1001/jama.2023.21019. PMID: 37824155; PMCID: PMC10570921.] - PMC - PubMed
Deeks 2022
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane, 2022. Available from https://www.handbook.cochrane.org.
Dobson 2015
    1. Dobson GP, Letson HL, Sharma R, Sheppard FR, Cap AP. Mechanisms of early trauma-induced coagulopathy: the clot thickens or not? Journal of Trauma and Acute Care Surgery 2015;79(2):301-9. [DOI: 10.1097/TA.0000000000000729] - DOI - PubMed
Donohue 2024
    1. Donohue JK, Gruen DS, Iyanna N, Lorence JM, Brown JB, Guyette FX, et al. Mechanism matters: mortality and endothelial cell damage marker differences between blunt and penetrating traumatic injuries across three prehospital clinical trials. Scientific Reports 2024;14(1):2747. [DOI: 10.1038/s41598-024-53398-1. PMID: 38302619; PMCID: PMC10834504.] - PMC - PubMed
Dujardin 2022
    1. Dujardin RWG, Kleinveld DJB, Gaarder C, Brohi K, Davenport RA, Curry N, et al. Coagulopathy underlying rotational thromboelastometry derangements in trauma patients: a prospective observational multicenter study. Anesthesiology 2022;137(2):232-42. - PubMed
Eastridge, 2019
    1. Eastridge BJ, Holcomb JB, Shackelford S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion 2019;59(S2):1423-8. [DOI: 10.1111/trf.15161. PMID: 30980749.] - PubMed
Fabes 2018
    1. Fabes J, Brunskill SJ, Curry N, Doree C, Stanworth SJ. Pro-coagulant haemostatic factors for the prevention and treatment of bleeding in patients without haemophilia. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No: CD010649. [DOI: 10.1002/14651858.CD010649] - DOI - PMC - PubMed
Geneen 2022
    1. Geneen LJ, Brunskill SJ, Doree C, Estcourt LJ, Green L. The difference in potential harms between whole blood and component blood transfusion in major bleeding: a rapid systematic review and meta-analysis of RCTs. Transfusion Medicine Reviews 2022;36(1):7-15. [DOI: 10.1016/j.tmrv.2021.10.003] [PMID: ] - DOI - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT. Version assessed 19 November 2016. Hamilton (ON): McMaster University (developed by Evidence Prime), 2014. Available at https://www.gradepro.org.
Hagemo 2014
    1. Hagemo JS, Stanworth S, Juffermans NP, Brohi K, Cohen M, Johansson PI, et al. Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study. Critical Care 2014;18(2):R52. - PMC - PubMed
Hartmann 2020
    1. Hartmann J, Walsh M, Grisoli A, Thomas AV, Shariff F, McCauley R, et al. Diagnosis and treatment of trauma-induced coagulopathy by viscoelastography. Seminars in Thrombosis and Hemostasis 2020;16(2):134-46. - PubMed
Herrera‐Escobar 2022
    1. Herrera-Escobar JP, Price MA, Reidy E, Bixby PJ, Hau K, Bulger EM, et al. Core outcome measures for research in traumatic injury survivors: The National Trauma Research Action Plan modified Delphi consensus study. Journal of Trauma and Acute Care Surgery 2022;92(5):916-23. [PMID: ] - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC editor(s). Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. Cochrane, 2011. Available from https://training.cochrane.org/handbook/PDF/v5.2/chapter-08.
Higgins 2019
    1. Higgins JPT, Eldridge S, Li T (editors). Chapter 23: Including variants on randomized trials (last updated October 2019). In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions 2nd Edition. Chichester (UK): John Wiley & Sons, 2019: 569–594. Available from www.training.cochrane.org/handbook.
Higgins 2022a
    1. Higgins JPT, Li T, Deeks JJ (editors). Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Available from https://www.training.cochrane.org/handbook.
Holcomb 2007
    1. Holcomb JB, Jenkins D, Rhee P, Johannigman J, Mahoney P, Mehta S, et al. Damage control resuscitation: directly addressing the early coagulopathy of trauma. Journal of Trauma: Injury, Infection, and Critical Care 2007;62(2):307-10. [DOI: 10.1097/TA.0b013e3180324124] - DOI - PubMed
Holcomb 2021
    1. Holcomb JB, Moore EE, Sperry JL, Jansen JO, Schreiber MA, Del Junco DJ, et al. Evidence-based and clinically relevant outcomes for hemorrhage control trauma trials. Annals of Surgery 2021;273(3):395-401. [DOI: 10.1097/SLA.0000000000004563. PMID: 33065652.] - PubMed
Hunt 2015
    1. Hunt H, Stanworth S, Curry N, Woolley T, Cooper C, Ukoumunne O, et al. Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No: CD010438. [DOI: 10.1002/14651858.CD010438.pub2] - DOI - PMC - PubMed
JLA PSP Major Trauma (International) 2023
    1. Major Trauma (International). https://www.jla.nihr.ac.uk/priority-setting-partnerships/major-trauma-in... (accessed 22 April 2025).
Khan 2014
    1. Khan S, Brohi K, Chana M, Raza I, Stanworth S, Gaarder C, et al. Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. Journal of Trauma Acute Care Surgery 2014;76(3):561-8. - PubMed
Lefebvre 2022
    1. Lefebvre C, Glanville J, Briscoe S, Featherstone R, Littlewood A, Marshall C, et al. Chapter 4: Searching for and selecting studies. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Available from www.handbook.cochrane.org.
Lockey 2018
    1. Lockey DJ. Improved trauma outcomes after the introduction of a trauma system in England. EClinicalMedicine 2018;2-3:3-4. - PMC - PubMed
Manning 2023
    1. Manning JE, Morrison JJ, Pepe PE. Prehospital resuscitation: what should it be? Advances in Surgery 2023;57(1):233-56. - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology 2009;62(10):1006-12. - PubMed
Mok 2021
    1. Mok G, Hoang R, Khan MW, Pannell D, Peng H, Tien H, et al. Freeze-dried plasma for major trauma - systematic review and meta-analysis. Journal of Trauma Acute Care Surgery 2021;90(3):589-602. - PMC - PubMed
Moore 2021
    1. Moore EE, Moore HB, Kornblith LZ, Neal MD, Hoffman M, Mutch NJ, et al. Trauma-induced coagulopathy. Nature Reviews Disease Primers 2021;7(1):30. [DOI: 10.1038/s41572-021-00264-3.] - DOI - PMC - PubMed
NICE 2016
    1. National Institute for Health and Clinical Excellence (NICE). Major trauma: assessment and initial management (NG39). https://www.nice.org.uk/guidance/ng39 (accessed 8 April 2016). - PubMed
Raza 2013
    1. Raza I, Davenport R, Rourke C, Platton S, Manson J, Spoors C, et al. The incidence and magnitude of fibrinolytic activation in trauma patients. Journal of Thrombosis and Haemostasis 2013;11(2):307-14. [DOI: 10.1111/jth.12078] - DOI - PubMed
RevMan Web 2020 [Computer program]
    1. ReviewManager Web [RevMan Web]. Version 1.22.1. The Cochrane Collaboration, 2020. Available at https://revman.cochrane.org.
Roberts 2013
    1. Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technology Assessment 2013;17(10):1-79. - PMC - PubMed
Roberts 2021
    1. Roberts I, Shakur-Still H, Aeron-Thomas A, Beaumont D, Belli A, Brenner A, et al. Tranexamic acid to reduce head injury death in people with traumatic brain injury: the CRASH-3 international RCT. Health Technology Assessment 2021;25(26):1-76. - PMC - PubMed
Roberts 2021b
    1. Roberts DJ, Bobrovitz N, Zygun DA, Kirkpatrick AW, Ball CG, Faris PD, et al. Evidence for use of damage control surgery and damage control interventions in civilian trauma patients: a systematic review. World Journal of Emergency Surgery 2021;16(1):10. - PMC - PubMed
Rossaint 2023
    1. Rossaint R, Afshari A, Bouillon B, Cerny V, Cimpoesu D, Curry N, et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Critical Care 2023;27(1):80. [DOI: 10.1186/s13054-023-04327-7. PMID: 36859355; PMCID: PMC9977110.] - PMC - PubMed
Rourke 2012
    1. Rourke C, Curry N, Khan S, Taylor R, Raza I, Davenport R, et al. Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes. Journal of Thrombosis and Haemostasis 2012;10(7):1342-51. [DOI: 10.1111/j.1538-7836.2012.04752.x] - DOI - PubMed
Schofield 2024
    1. Schofield H, Rossetto A, Armstrong PC, Allan HE, Warner TD, Brohi K, et al. Immature platelet dynamics are associated with clinical outcomes after major trauma. Journal of Thrombosis and Haemostasis 2024;22(4):926-35. - PubMed
Schünemann 2022
    1. Schünemann HJ, Higgins JPT, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Available from https://training.cochrane.org/handbook.
Sharfman 2021
    1. Sharfman ZT, Parsikia A, Rocker TN, Kahn MD, Sokol SC, Stone ME Jr, et al. Increased morbidity and mortality in elderly patients with lower extremity trauma and associated injuries: a review of 420,066 patients from the national trauma database. Injury 2021;52(4):757-66. - PubMed
Stanworth 2016
    1. Stanworth SJ, Davenport R, Curry N, Seeney F, Eaglestone S, Edwards A et al. Mortality from trauma haemorrhage and opportunities for improvement in transfusion practice. British Journal of Surgery 2016;103(4):357-65. - PubMed
Stanworth 2022
    1. Stanworth SJ, Dowling K, Curry N, Doughty H, Hunt BJ, Fraser L, et al. Haematological management of major haemorrhage: a British Society for Haematology Guideline. British Journal of Haematology 2022;198(4):654-67. [PMID: ] - PubMed
Sterne 2019
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:14898. - PubMed
Torres 2013
    1. Torres LN, Sondeen JL, Ji L, Dubick MA, Filho IT. Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats. Journal of Trauma and Acute Care Surgery 2013;75:759-66. [DOI: 10.1097/TA.0b013e3182a92514] - DOI - PubMed
Tucker 2021
    1. Tucker H, Davenport R, Green L. The role of plasma transfusion in pre-hospital haemostatic resuscitation. Transfusion Medicine Reviews 2021;35(4):91-5. [PMID: ] - PubMed
Tucker 2021a
    1. Tucker H, Avery P, Brohi K, Davenport R, Griggs J, Weaver A, et al. Outcome measures used in clinical research evaluating prehospital blood component transfusion in traumatically injured bleeding patients: a systematic review. Journal of Trauma and Acute Care Surgery 2021;91(6):1018-24. [PMID: ] - PubMed
Van Breugel 2020
    1. Van Breugel JMM, Niemeyer MJS, Houwert RM, Groenwold RHH, Leenen LPH, Van Wessem KJP. Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review. World Journal of Emergency Surgery 2020;15(1):55. [PMID: 10.1186/s13017-020-00330-3. PMID: 32998744; PMCID: PMC7526208.] - PMC - PubMed
WHO
    1. World Health Organisation. Injuries and Violence. https://who.int/news-room/fact-sheets/detail/injuries-and-violence 19 June 2024.
Wohlauer 2012
    1. Wohlauer MV, Moore EE, Thomas S, Sauaia A, Evans E, Harr J, et al. Early platelet dysfunction: an unrecognised role in the acute coagulopathy of trauma. Journal of the American College of Surgeons 2012;214(5):739-46. [DOI: 10.1016/j.jamcollsurg.2012.01.050] - DOI - PMC - PubMed
Wong 2020
    1. Wong HS, Curry NS, Davenport RA, Yu LM, Stanworth SJ. A Delphi study to establish consensus on a definition of major bleeding in adult trauma. Transfusion 2020;60(12):3023-38. [PMID: ] - PubMed
Zeng 2022
    1. Zeng L, Brignardello-Petersen R, Hultcrtantz M, Mustafa RA, Murad MH, Iorio A, et al. GRADE guidance 34: update on rating imprecision using a minimally contextualized approach. Journal of Clinical Epidemiology 2022;150:216-24. - PubMed

References to other published versions of this review

Wong 2017
    1. Wong H, Pottle J, Curry N, Stanworth SJ, Brunskill SJ, Davenport R, et al. Strategies for use of blood products for major bleeding in trauma. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No: CD012635. [DOI: 10.1002/14651858.CD012635] - DOI - PMC - PubMed

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