Leeper CM, et al. - The indication for transfusion, fibrinolysis status, and outcomes after plasma transfusion was assessed in injured pediatric patients. Researchers undertook a prospective observational study of subjects aged 0 years to 18 years presenting to Children’s Hospital of Pittsburgh of UPMC, a Level I academic pediatric trauma center, between November 1, 2015, and June 1, 2017. Findings revealed an independent association of plasma transfusion with sustained fibrinolysis shutdown (SD). In addition, there appeared an association of severe traumatic brain injury (TBI) with sustained SD; the combined effect of plasma transfusion and severe TBI is associated with extremely poor prognosis. They recommend not targetting plasma transfusion to INR thresholds but rather to rapid thromboelastography (rTEG) activated clotting time and clinical bleeding.