The preferred blood product for massive hemorrhage is packed red blood cells (PRBCs) because they primarily restore the oxygen-carrying capacity of the blood, which is critical in preventing tissue hypoxia and organ failure. During massive bleeding, rapid replacement of red cells is essential to maintain adequate oxygen delivery. While other components like plasma and platelets are important for coagulation, the first priority is to restore circulating volume and oxygen transport. Whole blood is less commonly used due to availability and logistics. Therefore, PRBCs are the cornerstone in managing massive hemorrhage initially.

Reference: Harrison’s Principles of Internal Medicine, Fauci et al., 20th Edition.