•Severe sepsis and septic shock are pro-haemolytic states that compromises the oxygen-carrying capacity of blood and is associated with high morbidity and mortality. •Blood transfusion and administration of blood-products are generally reserved as a late-stage treatment options in severe sepsis and septic shock after administration of fluids (crystalloids and colloids), vasopressor and inotropic agents. •Early administration of blood transfusion in severe sepsis and septic shock could improve oxygen delivery but the volume-expansion effects resulting from blood transfusion have not been studied.