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Need this article for a discussion if 1:1 or 1:0.5 RBC:FFP.........thanks !

The Journal of Trauma: Injury, Infection, and Critical Care:Volume 60(6) SupplementJune 2006pp S91-S96 
Massive Transfusion Practices Around the Globe and a Suggestion for a Common Massive Transfusion Protocol
[Article]
Malone, Debra L. MD, LTC USAF, SGRS; Hess, John R. MD, MPH; Fingerhut, Abe MD
From the Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA (D.L.M.); Departments of Pathology and Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA (J.R.H.); Department of Surgery, Poissy Centre Hospitalier Intercommunal, Poissy, France (A.F.).
Received for publication November 18, 2005.
Accepted for publication November 28, 2005.
J.R.H. supported by NIH grant 1U01HL072359-01.
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or reflecting the views of the Department of Defense or United States Government. One of the authors is an employe of the U.S. government. This work was prepared as part of her official duties and, as such, there is no copyright to be transferred.
Address for reprints: Dr. Debra L. Malone, 10 North Greene Street, Room 5C120, Baltimore MD 21228; email: mdlm11 at aol.com, debra. malone at pentagon.af.mil.
Abstract
Background: Massive transfusion, the administration of 10 to more than 100 units of red blood cells (RBC) in less than 24 hours, can be a life saving therapy in the treatment of severe injury. The rapid administration of large numbers of RBC, along with sufficient plasma and platelets to treat or prevent coagulopathy, is frequently a disorderly process. Patient care and collaborative research might be aided with a common protocol.
Methods: The authors polled trauma organizations and trauma centers to find examples of massive transfusion protocols. The goals and ease of use of these protocols were evaluated.
Results: Massive transfusion protocols exist at a relatively small number of large and well-organized trauma centers. Most of these protocols are designed to treat pre-existing and/or ongoing coagulopathy.
Conclusions: The evidence would suggest that prevention of coagulopathy is superior to its treatment. Simple ratios such as 1:1:1 RBC:plasma:platelets have the benefit of ease of use and the relatively higher plasma and platelet doses appear to be associated with improved outcome. Such a standard protocol can foster multicenter research on resuscitation and hemorrhage control. The fixed volume ratios might allow the number and rate of administered units of RBC to be used as surrogates for blood loss and primary treatment effect.
© 2006 Lippincott Williams & Wilkins, Inc.

Ivan Hronek MD 
Los Angeles, CA 
http://health.groups.yahoo.com/group/Anesthideas/ 
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

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