1:1:1 blood transfusion ratio

The 1:1:1 blood transfusion ratio is a resuscitation protocol designed for the management of trauma patients with life-threatening hemorrhage. This protocol involves the administration of plasma, platelets, and packed red blood cells (RBCs) in a balanced 1:1:1 unit ratio, which more closely approximates the composition of whole blood compared to traditional transfusion strategies. The goal of this approach is to prevent or mitigate trauma-induced coagulopathy and improve survival by simultaneously addressing volume loss, oxygen-carrying capacity, and the depletion of clotting factors and platelets. This specific ratio was the primary intervention evaluated in the Phase III PROPPR (Pragmatic, Randomized Optimal Platelet and Plasma Ratios) trial, which was led by the University of Texas Health Science Center at Houston. The trial demonstrated that the 1:1:1 ratio improved hemostasis and reduced deaths from exsanguination within the first 24 hours.

Other names

1:1:1 plasma:platelets:RBC ratioPragmatic Randomized Optimal Platelet and Plasma Ratiosblood transfusion-The University of Texas Health Science Center, Houston-trauma