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Invited Commentary
June 2017

Applying Trauma Transfusion Practices to Nontrauma Care: A Cautionary Tale

Author Affiliations
  • 1Department of Surgery, Stanford University School of Medicine, Stanford, California
  • 2Surgical Service, Palo Alto Veterans Health Care System, Palo Alto, California
JAMA Surg. 2017;152(6):580. doi:10.1001/jamasurg.2017.0091

The publication by Borgmann et al1 changed combat casualty care, shifting transfusion practices to a more balanced ratio of plasma to red blood cells. The crossover into civilian trauma quickly ensued and even continued after 2 key trials (Prospective, Observational, Multicenter, Major Trauma Transfusion and Pragmatic Randomized Optimal Platelet and Plasma Ratios) showed no 30-day survival benefits.2,3 A subsequent expansion to nontrauma massive transfusion cases followed. In this issue of JAMA Surgery, Mesar and colleagues4 describe transfusion ratios in all patients with massive transfusions and assess survival benefit through hospital specialty and ratios.

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