In the absence of randomized, controlled trials,
retrospective studies of military casualties1 and,
later, similar studies of civilian casualties2 showing
improved survival with transfusion of 1 U of
fresh-frozen plasma for each unit of red cells
have resulted in earlier administration of an increased
number of units of fresh-frozen plasma.
However, these studies have been criticized,
particularly for methodologic flaws that include
survival bias (i.e., patients who did not survive
were not transfused with fresh-frozen plasma)
and heterogeneity between studies.3
In the absence of randomized, controlled trials,retrospective studies of military casualties1 and,later, similar studies of civilian casualties2 showingimproved survival with transfusion of 1 U offresh-frozen plasma for each unit of red cellshave resulted in earlier administration of an increasednumber of units of fresh-frozen plasma.However, these studies have been criticized,particularly for methodologic flaws that includesurvival bias (i.e., patients who did not survivewere not transfused with fresh-frozen plasma)and heterogeneity between studies.3
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