Related Experiment Video
Updated: Nov 19, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Freeze-dried plasma for major trauma - Systematic review and meta-analysis
Garrick Mok1, Richard Hoang, Montaha Wajid Khan
1From the Department of Emergency Medicine (G.M., R.H.), The Ottawa Hospital, University of Ottawa, Ottawa, Canada; Department of Critical Care (M.W.K.), Liverpool Hospital, Sydney, Australia; Department of Surgery (D.P., H.T., A.N., L.T.d.L.), Sunnybrook Health Sciences Centre, University of Toronto; Toronto Research Centre (H.P.), Defence Research and Development Canada; Department of Laboratory Medicine and Molecular Diagnostics (J.C.), Sunnybrook Health Sciences Centre; Department of Laboratory Medicine and Pathobiology (J.C.), Department of Anesthesia and Pain Medicine (K.K.), University of Toronto, and Department of Surgery (A.B.), Saint Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Background:
Treatment of acute trauma coagulopathy has shifted toward rapid replacement of coagulation factors with frozen plasma (FP). There are logistic difficulties in providing FP. Freeze-dried plasma (FDP) may have logistical advantages including easier storage and rapid preparation time. This review assesses the feasibility, efficacy, and safety of FDP in trauma.
Study Design And Methods:
Studies were searched from Medline, Embase, Cochrane Controlled Trials Register, ClinicalTrials.gov, and Google Scholar. Observational and randomized controlled trials (RCTs) assessing FDP use in trauma were included. Trauma animal models addressing FDP use were also included. Bias was assessed using validated tools. Primary outcome was efficacy, and secondary outcomes were feasibility and safety. Meta-analyses were conducted using random-effect models. Evidence was graded using Grading of Recommendations Assessment, Development, and Evaluation profile.
Results:
Twelve human studies (RCT, 1; observational, 11) and 15 animal studies were included. Overall, studies demonstrated moderate risk of bias. Data from two studies (n = 119) were combined for meta-analyses for mortality and transfusion of allogeneic blood products (ABPs). For both outcomes, no difference was identified. For mortality, pooled odds ratio was 0.66 (95% confidence interval, 0.29-1.49), with I2 = 0%. Use of FDP is feasible, and no adverse events were reported. Animal data suggest similar results for coagulation and anti-inflammatory profiles for FP and FDP.
Conclusion:
Human data assessing FDP use in trauma report no difference in mortality and transfusion of ABPs in patients receiving FDP compared with FP. Data from animal trauma studies report no difference in coagulation factor and anti-inflammatory profiles between FP and FDP. Results should be interpreted with caution because most studies were observational and have heterogeneous population (military and civilian trauma) and a moderate risk of bias. Well-designed prospective observational studies or, preferentially, RCTs are warranted to answer FDP's effect on laboratory (coagulation factor levels), transfusion (number of ABPs), and clinical outcomes (organ dysfunction, length of stay, and mortality).
Level Of Evidence:
Systematic review and meta-analysis, level IV.
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care