LAUSR

Massive bleeding remains a major source of morbidity and mortality worldwide. Recent studies have shed light on the pathophysiology of traumatic‐induced coagulopathy and the central role of endotheliopathy. Transfusion therapy has changed dramatically in the last decade with use of red cells and plasma in a 1:1 ratio. The use of early transfusion increases the likelihood of a favorable outcome. Early intervention‐preferably less than 60 min of injury‐is a major factor in improved survival. Experience with dried plasma products—lyophilized or freeze‐dried—in Europe and South Africa has demonstrated both safety and efficacy. Dry plasma products are not available in the United States but several products are in development. Spray‐dried plasma contains clinically meaningful levels of coagulation activity and in vitro data suggest robust ability to generate thrombus. The decentralized, blood‐center based manufacturing model of spray‐dried plasma offers advantages for availability to meet routine and extraordinary demands.