Evidence map›Paper›PMID 32890339›Full record

Trial reportThe journal of trauma and acute care surgery2020

Group A emergency-release plasma in trauma patients requiring massive transfusion.

Amory de Roulet, Jeffrey D Kerby, Jordan A Weinberg, Richard H Lewis, Jay P Hudgins, Ira A Shulman, Erin E Fox, John B Holcomb, Karen J Brasel, Eileen M Bulger and 9 more

Abstract readClinical Trial, Phase IIIMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The journal of trauma and acute care surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025
    Pooled it
  3. Guideline
  4. Freeze-dried plasma for major trauma - Systematic review and meta-analysis.The journal of trauma and acute care surgery · 2021
    Pooled it
  5. Pooled it
  6. Review
  7. Article
  8. Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Amory de RouletFrom the Division of General Surgery (A.d.R.), Department of Surgery, New York Presbyterian Queens, Flushing, New York; Division of Trauma, Burns and Surgical Critical Care (J.D.K.), Department of Surgery, School of Medicine, University of Alabama, Birmingham, Alabama; Division of General Surgery (J.A.W.), Department of Surgery, Dignity Health Medical Group Arizona, Phoenix, Arizona; Department of Surgery (R.H.L.Jr), University of Tennessee Health Science Center, Memphis, Tennessee; Department of Pathology (J.P.H., I.A.S.), LAC+USC Medical Center, University of Southern California, Los Angeles, California; Center for Translational Injury Research (E.E.F., J.B.H.), Division of Acute Care Surgery, Department of Surgery, University of Texas Health Science Center, Houston, Texas; Division of Trauma (K.J.B., M.A.S.), Critical Care and Acute Care Surgery, School of Medicine, Oregon Health and Science University, Portland, Oregon; Division of Trauma and Critical Care (E.M.B.), Department of Surgery, School of Medicine, University of Washington, Seattle, Washington; Department of Surgery (M.J.C.), University of Colorado, Denver, Colorado; Center for Translational Injury Research (B.A.C.), Division of Acute Care Surgery, Department of Surgery, University of Texas Health Science Center, Houston, Texas; Division of Trauma and Surgical Critical Care (T.C.F.), Department of Surgery, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Trauma (T.O.), Critical Care and Emergency Surgery, Department of Surgery, University of Arizona, Tucson, Arizona; Trauma and Acute Care Service (S.R.), St. Michael's Hospital, Toronto, Ontario, Canada; R Adams Crowley Shock Trauma Center (T.M.S.), University of Maryland, Baltimore, Maryland; and Division of Trauma and Critical Care (K.I.), LAC+USC Medical Center, University of Southern California, Los Angeles, California.
Jeffrey D Kerby
Jordan A Weinberg
Richard H Lewis
Jay P Hudgins
Ira A Shulman
Erin E Fox
John B Holcomb
Karen J Brasel
Eileen M Bulger
Mitchell Jay Cohen
Bryan A Cotton
Timothy C Fabian
Terence O'Keeffe
Sandro Rizoli
Thomas M Scalea
Martin A Schreiber
Kenji Inaba
PROPPR Study Group

Funding

Resuscitation Outcomes Consortium (ROC) Data Coordinating CenterU01HL077863 · NHLBI · UNIVERSITY OF WASHINGTON · PI MAY, SUSANNE · 2004 to 2015
$125.1M
Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
CIHR CRR-120612NCATS NIH HHS UL1 TR001855NHLBI NIH HHS U01 HL077863
6 · The paper itself

Abstract

backgroundBoth groups A and AB plasma have been approved for emergency-release transfusion in acutely bleeding trauma patients before blood grouping being performed. The safety profile associated with this practice has not been well characterized, particularly in patients requiring massive transfusion.

methodsThis secondary analysis of the Pragmatic, Randomized, Optimal Platelet and Plasma Ratios trial examined whether exposure to group A emergency-release plasma (ERP) was noninferior to group AB ERP. We also examined patients whose blood groups were compatible with group A ERP versus patients whose blood groups were incompatible with group A ERP. Outcomes included 30-day mortality and complication rates including systemic inflammatory response syndrome, infection, renal injury, pulmonary dysfunction, and thromboembolism.

resultsOf the 680 patients predicted to receive a massive transfusion, 584 (85.9%) received at least 1 U of ERP. Of the 584 patients analyzed, 462 (79.1%) received group AB and 122 (20.9%) received group A ERP. Using a hazard ratio (HR) of 1.35 as the noninferiority margin, transfusion with group A versus group AB ERP was not associated with increased thromboembolic rates (HR, 0.52; 95% confidence interval [CI], 0.31-0.90). Mortality (HR, 1.15; 95% CI, 0.91-1.45) and nonfatal complication rates (HR, 1.24; 95% CI, 0.87-1.77) were inconclusive. In the subgroup analysis, transfusion with incompatible ERP (group B or AB patients receiving group A ERP) was not associated with increased nonfatal complications (HR, 1.02; 95% CI, 0.80-1.30). There were no reported hemolytic transfusion reactions.

conclusionThe use of ERP is common in patients requiring massive transfusion and facilitates the rapid balanced resuscitation of patients who have sustained blood loss. Group A ERP is an acceptable option for patients requiring massive transfusion, especially if group AB ERP is not readily available. LEVEL OF EVIDENCE: Therapeutic/Care Management, level IV; Prognostic, level III.

Indexed as

Blood Group IncompatibilityPlasmaAdultBlood Component TransfusionBlood Grouping and CrossmatchingEmergenciesFemaleHemorrhageHumansInjury Severity ScoreMaleMiddle AgedProportional Hazards ModelsResuscitationRisk FactorsTrauma Centers

Identifiers

PMID32890339
PMCPMC7830815

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.