Does a balanced transfusion ratio of plasma to packed red blood cells improve outcomes in both trauma and surgical patients? A meta-analysis of randomized controlled trials and observational studies.

•Balanced Transfusion effect on Mortality Rates.•High Ratio is associated with better survival.•A FFP:RBC ratio of 1:1.5 achieved the highest survival rates.•No association between the transfusion ratio and the incidence of ARDS and ALI.