CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-14). The draft was written by AI, the existence of all 3 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2564 · Search date 2026-08-14 · Methodology v0.7

Two units of prehospital thawed plasma,
does it really help with Reduced 28- to 30-day mortality versus crystalloid-centered standard resuscitation?

30-Second Summary
B
Evidence Grade B · 76 · Safety caution
Prehospital plasma improved survival during longer air transport but not during rapid urban ground transport.
The trials did not identify increases in nosocomial infection or transfusion reactions, but plasma carries rare risks of transfusion-transmitted infection, transfusion-related acute lung injury (TRALI), and transfusion-associated circulatory overload (TACO). Trauma and transfusion protocols with immediate monitoring are required.
What the
research shows
The grade is B. In 501 air-transport patients, PAMPer found 30-day mortality of 23.2% versus 33.0%, difference -9.8 points (95% CI -18.6 to -1.0). In contrast, COMBAT's 125-person urban ground-transport analysis found 28-day mortality of 10/65 (15%) versus 6/60 (10%), effect estimate 1.54 (95% CI 0.60 to 3.98), P=.37. However, COMBAT's broad interval includes PAMPer's relative-risk estimate of about 0.70, and median transport differed at roughly 16 to 19 versus 40 to 42 minutes. The null study is imprecise and context differs, so it does not establish statistical conflict; two human trials exist, making this B with 76 points rather than unknown.
What the
ads claim
Two units of thawed plasma can be delivered before hospital arrival, and survival improved during longer air transport. Advertising benefit across rapid urban transfers without transport context would exceed the trials.
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Useful facts when choosing a product

  • PAMPer and COMBAT both tested two units of prehospital plasma but differed in transport mode and time.
  • Existing plasma verdicts in the corpus concern albumin, platelet-rich plasma, or young-donor plasma; this verdict concerns thawed plasma during trauma transport.
  • Hunter B Moore, listed as Moore HB, is COMBAT's first author; Ernest E Moore is second.
Gap Measurement · Verdict 2564 · B 76
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Sperry JL, Guyette FX, Brown JB, Yazer MH and colleagues conducted the multicenter cluster-randomized PAMPer trial with U.S. Army Medical Research and Materiel Command funding. COMBAT's first author was Moore HB; Moore EE was second author. COMBAT randomized 144 but used 125 in its main analysis after postrandomization exclusions, was small, and stopped for futility. Both trials used U.S. Department of Defense-family public funding, so different investigators did not establish replication from a separate funding source.

02

Why this is classified as B (76)

PAMPer provided publicly funded hard-outcome benefit. COMBAT was imprecise, included the PAMPer effect estimate, and differed in transport time, so it was neither exact replication nor true conflict; one direct confirmatory trial gives B with 76 points.

Counterpoint. B does not establish benefit during every transport duration; benefit may be concentrated when definitive blood access is delayed.

Rejudgment record. Cross-check applied — We cross-checked mortality denominators and intervals, transport times, analysis populations, funding, and whether COMBAT excluded the PAMPer effect across both trials.

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (B).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Reduced 30-day mortality during longer air transportBPAMPer found an absolute difference of -9.8 points.
Reduced 28-day mortality during rapid urban ground transportDCOMBAT found 15% versus 10%, P=.37, without benefit but did not exclude the PAMPer effect.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Multicenter cluster-randomized air-medical transport trial271U.S. Army Medical Research and Materiel Command30-day mortality23.2% versus 33.0%, difference -9.8 points (95% CI -18.6 to -1.0), P=.03Survival benefit during longer air transport
Study 2Single-center randomized urban ground-transport trial60U.S. Department of Defense and NIH support28-day mortality10/65 (15%) versus 6/60 (10%), effect estimate 1.54 (95% CI 0.60 to 3.98), P=.37Null result during rapid urban transport
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Receipt — 3 References

All 3 cited sources were verified for existence at the original page (as of 2026-08-14).

Sperry JL, Guyette FX, Brown JB, et al. Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock. N Engl J Med. 2018;379(4):315-326. PMID: 30044935. DOI: 10.1056/NEJMoa1802345. NCT01818427.
checked
Moore HB, Moore EE, Chapman MP, et al. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018;392(10144):283-291. PMID: 30032977. DOI: 10.1016/S0140-6736(18)31553-8. NCT01838863.
checked
Pusateri AE, Moore EE, Moore HB, et al. Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes. JAMA Surg. 2020;155(2):e195085. PMID: 31800045. DOI: 10.1001/jamasurg.2019.5085.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none

Cite this verdict

Two units of prehospital thawed plasma x trauma mortality Evidence Grade B card
[Chamgap] Two units of prehospital thawed plasma x trauma mortality — Evidence Grade B·76. 3 cited sources checked. Source: https://chamgap.com/en/verdicts/general/prehospital-thawed-plasma-trauma-mortality/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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