Recent studies have highlighted the importance of expeditious transfusion of plasma, platelets and red blood cells in a 1:1:1 ratio for severe trauma patients who are at risk of exsanguination. Since thawing plasma can be time-consuming, a recent study published in TRANSFUSION examined the hemostatic properties of thawed and liquid plasma over several days of storage. Briefly, during initial processing after donation 17 pooled ABO-matched plasma units were split into a liquid plasma unit and a frozen unit (subsequently thawed and stored for up to five days), and multiple hemostasis parameters, coagulation factors, and platelet activation assays were performed. A further 119 liquid plasma samples were analyzed for platelet activation and cellular content. Liquid plasma at day seven was comparable to thawed plasma at day five by every assay. However, after 11 days of storage, coagulation factors started to decline in liquid plasma, and cold-induced contact activation was observed after 28 days of storage. Although further research is needed to determine the optimal storage time, liquid plasma is logistically easier to use for many severe trauma patients.
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