To investigate the current practice in the diagnosis and treatment of hemorrhagic shock and trauma-induced coagulopathy (TIC) in ICUs across China.

A nationwide questionnaire-based survey was conducted among 1733 critical care physicians from 814 secondary and tertiary hospitals across all 31 provincial-level regions in China. The collected data were statistically analyzed to comprehensively evaluate key aspects and influencing factors in the management of these conditions.

The majority of respondents were from comprehensive ICUs in tertiary Grade A teaching hospitals. Heart rate (87.88%), blood pressure (93.83%), prothrombin time (98.27%), and fibrinogen level (94.40%) were the most commonly used indicators for diagnosing hemorrhagic shock and TIC and for guiding transfusion decisions. Physicians' perceptions regarding the choice of resuscitation fluids and blood products, goals of coagulation management, target ionized calcium level, core temperature control, and deep vein thrombosis prophylaxis were largely consistent with the European Guideline on Management of Major Bleeding and Coagulopathy Following Trauma: Sixth Edition. Several key discrepancies with the guideline were identified: viscoelastic testing was not widely used in clinical practice; fresh frozen plasma was still commonly used to correct hypoalbuminemia; calcium gluconate was preferred over calcium chloride for supplementing ionized calcium; and graduated compression stockings were considered effective for preventing lower extremity deep vein thrombosis.

Chinese intensivists demonstrate a relatively high level of knowledge in managing hemorrhagic shock and TIC.However, significant opportunities for standardization and improvement remain. Targeted training programs and quality control initiatives based on these survey findings are warranted to bridge the gap between current practices and evidence-based guidelines.