Table 1 Arguments for and against the adoption of early formula-driven haemostatic resuscitation in trauma
From: Clinical review: Fresh frozen plasma in massive bleedings - more questions than answers
| Â | Pros | Cons |
|---|---|---|
Mortality | Retrospective studies suggesting a reduction in mortality from exsanguinations | Data limited by survivorship bias |
| Â | Â | Increase in FFP and platelet use might increase the risk of acute lung injury, multiple organ failure, thrombosis, sepsis and death |
Coagulopathy | Prevention and treatment of coagulopathy due to transfusion of clotting factors | Difficult to identify patients early on who will develop coagulopathy and in fact need transfusion of FFP and platelets |
| Â | Minimize crystalloid use (decrease the risk of dilution) | Uncertainty about the ideal dose of FFP in the trauma situation |
Laboratory tests | No need for coagulation tests | Unnecessary exposure to AB plasma (in some countries, a higher risk of transfusion-related acute lung injury due to higher proportion of female donors) |
| Â | Avoid the delay of waiting for blood test results | Â |
Blood bank systems | More timely issuing of blood components | The waste of FFP will increase (shortage of AB plasma) |
| Â | No time needed to thaw FFP (AB plasma available at all times) | May increase the complications associated with FFP and platelet transfusion |
| Â | Decrease the need for communication between blood bank and the medical team | Â |