Purpose: To develop evidence-based clinical practice recommendations regarding transfusion practices and transfusion in bleeding critically ill adults.

Methods: A taskforce involving 15 international experts and 2 methodologists used the GRADE approach to guideline development. The taskforce addressed three main topics: transfusion support in massively and non-massively bleeding critically ill patients (transfusion ratios, blood products, and point of care testing) and the use of tranexamic acid. The panel developed and answered structured guideline questions using population, intervention, comparison, and outcomes (PICO) format.

Results: The taskforce generated 26 clinical practice recommendations (2 strong recommendations, 13 conditional recommendations, 11 no recommendation), and identifed 10 PICOs with insufcient evidence to make a recommendation.

Conclusions: This clinical practice guideline provides evidence-based recommendations for the management of massively and non-massively bleeding critically ill adult patients and identifes areas where further research is needed.

目的：针对出血危重成人患者的输血实践和输血制定循证临床实践建议。

方法：由15名国际专家和2名方法学家组成的工作组使用 GRADE 方法制定指南。工作组讨论了三个主要主题：大量和非大量出血重症患者的输血支持（输血比例、血液制品和床旁检测）和氨甲环酸的使用。该小组使用人群、干预、比较和结果 (PICO) 格式制定并回答了结构化指南问题。

结果：工作组生成了26项临床实践建议（2项强烈建议，13项条件性建议，11项无建议），并确定了10项PICO，其提供的建议证据不充分。

结论：本临床实践指南为大量和非大量出血的成人重症患者的管理提供了循证建议，并确定了需要进一步研究的领域。