To the Editor Dr Holcomb and the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) study collaborative1 completed a multicenter randomized trial with the hypothesis that a 1:1:1 ratio for units of plasma and platelets to red blood cells (RBCs) would be superior to a 1:1:2 ratio. These investigators did not find a survival advantage in their primary outcomes of 24-hour and 30-day mortality, achieving greater than 95% power to detect a 10% mortality reduction.
Moore HB, Moore EE, Gonzalez E. Mortality and Ratio of Blood Products Used in Patients With Severe Trauma. JAMA. 2015;313(20):2077. doi:10.1001/jama.2015.4418