Despite the lack of evidence that bleeding
after surgery and gastrointestinal or obstetric
hemorrhage are associated with hemostatic
changes similar to those in acute traumatic coagulopathy,
the early use of a transfusion ratio
of fresh-frozen plasma to red cells of 1:1 or 1:2
has become widespread. This increased use of
plasma is not risk-free, since the incidence of
transfusion-related acute lung injury is increased,4
as may be the risk of the acute respiratory distress
syndrome (ARDS). In one study involving
trauma patients requiring a nonmassive transfusion
(