1:1

Letter to editorlink_to_subscribed_fulltex

Characterization of sports-related injury attendance at trauma centres in Hong Kong

Conference Theme: Enhancing Health - 協作同心‧醫澤社

Pediatric trauma: causes and pattern in Hong Kong

Conference Theme: Enhancing Health - 協作同心‧醫澤社

Fresh-frozen plasma transfusion strategy in trauma with massive and ongoing bleeding. Common (sense) and sensibility

Comment in Resuscitation. 2011 Aug;82(8):1104During trauma resuscitation involving massive transfusion, the best fresh-frozen plasma to packed red blood cells ratio is unknown. No randomised controlled trial (RCT) is available on this subject, although there are plenty of observational studies suggesting that the ratio should be about 1:1. This ratio also makes more physiological sense, and we suggest that in patients with massive and ongoing bleeding, it is a sensible strategy with which to start resuscitation. © 2010 Elsevier Ireland Ltd.link_to_subscribed_fulltex

Prevalence of survivor bias in observational studies on fresh frozen plasma: erythrocyte ratios in trauma requiring massive transfusion

Observational studies on transfusion in trauma comparing high versus low plasma:erythrocyte ratio were prone to survivor bias because plasma administration typically started later than erythrocytes. Therefore, early deaths were categorized in the low plasma:erythrocyte group, whereas early survivors had a higher chance of receiving a higher ratio. When early deaths were excluded, however, a bias against higher ratio can be created. Survivor bias could be reduced by performing before-and-after studies or treating the plasma:erythrocyte ratio as a time-dependent covariate.We reviewed 26 studies on blood ratios in trauma. Fifteen of the studies were survivor bias-unlikely or biased against higher ratio; among them, 10 showed an association between higher ratio and improved survival, and five did not. Eleven studies that were judged survivor bias-prone favoring higher ratio suggested that a higher ratio was superior.Without randomized controlled trials controlling for survivor bias, the current available evidence supporting higher plasma:erythrocyte resuscitation is inconclusive.link_to_subscribed_fulltex