Trial reportInjury2014
Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation.
Trial report in Injury, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 144 citations in OpenAlex.
- Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025Pooled it
- Use of Bayesian Statistics to Reanalyze Data From the Pragmatic Randomized Optimal Platelet and Plasma Ratios Trial.JAMA network open · 2023Trial
- Acquired antithrombin deficiency is a risk factor for venous thromboembolism after major trauma.Thrombosis research · 2021Trial
- Group A emergency-release plasma in trauma patients requiring massive transfusion.The journal of trauma and acute care surgery · 2020Trial
- Examining 1:1 vs. 4:1 Packed Red Blood Cell to Fresh Frozen Plasma Ratio Transfusion During Pediatric Burn Excision.Journal of burn care & research : official publication of the American Burn Association · 2020Trial
- Cost-effectiveness evaluation of the PROPPR trial transfusion protocols.Transfusion · 2020Trial
- Characterizing red blood cell age exposure in massive transfusion therapy: the scalar age of blood index (SBI).Transfusion · 2019Trial
- TEG Lysis Shutdown Represents Coagulopathy in Bleeding Trauma Patients: Analysis of the PROPPR Cohort.Shock (Augusta, Ga.) · 2019Trial
- Elevated Syndecan-1 after Trauma and Risk of Sepsis: A Secondary Analysis of Patients from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial.Journal of the American College of Surgeons · 2018Trial
- A comparison of resuscitation intensity and critical administration threshold in predicting early mortality among bleeding patients: A multicenter validation in 680 major transfusion patients.The journal of trauma and acute care surgery · 2018Trial
- Risk Factors for the Development of Acute Respiratory Distress Syndrome Following Hemorrhage.Shock (Augusta, Ga.) · 2018Trial
- Platelet transfusions improve hemostasis and survival in a substudy of the prospective, randomized PROPPR trial.Blood advances · 2018Trial
- Outcomes after concomitant traumatic brain injury and hemorrhagic shock: A secondary analysis from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios trial.The journal of trauma and acute care surgery · 2017Trial
- Every minute counts: Time to delivery of initial massive transfusion cooler and its impact on mortality.The journal of trauma and acute care surgery · 2017Trial
- Design of a cluster-randomized minority recruitment trial: RECRUIT.Clinical trials (London, England) · 2017Trial
- Trial
- A controlled resuscitation strategy is feasible and safe in hypotensive trauma patients: results of a prospective randomized pilot trial.The journal of trauma and acute care surgery · 2015Trial
- Trial
- Pediatric clinical trials in emergency or intensive care settings using exception from informed consent and waiver of informed consent regulations.World journal of emergency medicine · 2026Article
- Adopting common data elements (CDEs) for the National Trauma Research Repository (NTRR): the results of an acute hospital Delphi survey.Trauma surgery & acute care open · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors at 13 institutions in 2 countries.
Funding
Abstract
backgroundForty percent of in-hospital deaths among injured patients involve massive truncal haemorrhage. These deaths may be prevented with rapid haemorrhage control and improved resuscitation techniques. The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial was designed to determine if there is a difference in mortality between subjects who received different ratios of FDA approved blood products. This report describes the design and implementation of PROPPR. STUDY
designPROPPR was designed as a randomized, two-group, Phase III trial conducted in subjects with the highest level of trauma activation and predicted to have a massive transfusion. Subjects at 12 North American level 1 trauma centres were randomized into one of two standard transfusion ratio interventions: 1:1:1 or 1:1:2, (plasma, platelets, and red blood cells). Clinical data and serial blood samples were collected under Exception from Informed Consent (EFIC) regulations. Co-primary mortality endpoints of 24h and 30 days were evaluated.
resultsBetween August 2012 and December 2013, 680 patients were randomized. The overall median time from admission to randomization was 26min. PROPPR enrolled at higher than expected rates with fewer than expected protocol deviations.
conclusionPROPPR is the largest randomized study to enrol severely bleeding patients. This study showed that rapidly enrolling and successfully providing randomized blood products to severely injured patients in an EFIC study is feasible. PROPPR was able to achieve these goals by utilizing a collaborative structure and developing successful procedures and design elements that can be part of future trauma studies.
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