Dried Plasma – Where Are We and Where Next?

• In treating traumatic haemorrhage, pre-hospital transfusion is likely beneficial • The mechanism of effect of plasma transfusion in trauma is not fully understood. • Prehospital plasma transfusion is logistically challenging to deliver expediently • Dried plasma is an attractive solution to this challenge • There is a paucity of clinical data on dried plasma and more studies are needed Traumatic haemorrhage is a major cause of morbidity and mortality, in both military and civilian settings. Early haemostatic resuscitation including red cell and plasma administration is a mainstay of treatment. Pre-hospital blood transfusion benefits trauma patients, but delivery is logistically challenging. Dried plasma, stored in ambient conditions and reconstituted rapidly, without specialist equipment, offers a pragmatic solution to the logistical barriers to pre-hospital transfusion. This review outlines mechanisms of action, and approaches to evaluating efficacy of plasma, summarises advances in drying technologies and their sequelae on plasma quality, and critically appraises four published studies.