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However, FFP is associated with higher infection and sepsis risks. This study investigated the impact of resuscitation changes on inflammatory complications and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 11-year cohort study included severely injured patients (&gt;\u200915 years) admitted to a Level-1 Trauma Center ICU. Exclusions included isolated head injuries, drowning, asphyxiation, burns, and deaths\u2009&lt;\u200948\u00a0h. Data on demographics, resuscitation, inflammatory complications (MODS, ARDS, infections, thromboembolism), and mortality were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 585 patients (median age 46,72% male, ISS 29, 94% blunt injuries), 18% developed MODS, 3% ARDS, 45% infections, 9% thromboembolism, and 14% died. Over time, crystalloids\u2009\u2264\u200924\u00a0h decreased while FFP\u2009\u2264\u200924\u00a0h increased, correlating with reduced ARDS but increased thromboembolic events. Crystalloids\u2009\u2264\u200924\u00a0h independently predicted MODS, infections, and mortality, while FFP\u2009\u2264\u200924\u00a0h was linked to MODS and thromboembolism. Causes of death other than neurological included MODS (5%), sepsis (3%), and ARDS (1%), with no deaths from thromboembolic complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Resuscitation evolved toward less crystalloids and more FFP\u2009\u2264\u200924\u00a0h, likely reducing ARDS but increasing thromboembolic complications, while other outcomes remained comparable. Low mortality from inflammatory complications suggests these complications were mild. The anti-inflammatory, immune-modulating effect of FFP might have played a role in the attenuation of these complications, supporting current resuscitation strategies. However, improved identification of patients who require FFPs may help reduce thromboembolism. In the future, optimal FFP dosage should be determined to balance coagulopathy correction, blood volume restoration, and management of the inflammatory response following trauma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-025-02905-8","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T05:51:34Z","timestamp":1750657894000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Change in resuscitation influenced development and severity of inflammatory complications in severely injured"],"prefix":"10.1007","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1166-0990","authenticated-orcid":false,"given":"Karlijn J. P.","family":"van Wessem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim E. 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