Fresh unrefrigerated, leucocyte depleted whole blood contains the red cells, platelets and plasma component of donor blood. It has limited indications.
Only use whole blood for patients who have a symptomatic deficit in oxygen-carrying capacity combined with hypovolaemia of sufficient degree to be associated with shock, particularly in clinical situations where the transfusion of viable platelets and therapeutic levels of labile coagulation factors V and VIII are also required.
If only a symptomatic deficit in oxygen-carrying capacity is present, the component of choice is red cells.
Do not use Whole Blood in the following circumstances:
if anaemia can be treated with specific medications such as iron, vitamin B12, folic acid or recombinant erythropoietin and when the patient’s clinical condition permits sufficient time for these agents to promote erythropoiesis.
when blood volumes can be safely and adequately replaced with other volume expanders such as 0.9% Sodium Chloride Injection, Hartmann’s Solution or appropriate colloids.
Each unit raises the haemoglobin concentration by approximately 10 g/L in an average sized adult.
Whenever possible, use blood of identical ABO and Rh(D) group to the recipient.
