Need For Blood Products Research Articles

015 Can we predict liver fibrosis preoperative in patients who undergo heart failure surgery and does it influence postoperative liver function?

BackgroundLiver dysfunction is common in patients with heart failure and may progress to irreversible fibrosis, which is predictive of poor prognosis. Our objective was to determine the frequency of liver...

Guidelines on oral anticoagulation with warfarin – fourth edition

Guidelines on oral anticoagulation with warfarin – fourth edition

Administration of recombinant activated factor VII in the intensive care unit after complex cardiovascular surgery: Clinical and economic outcomes

Refractory bleeding after complex cardiovascular surgery often leads to increased length of stay, cost, morbidity, and mortality. Recombinant activated factor VII administered in the intensive care unit can reduce bleeding, transfusion, and surgical re-exploration. We retrospectively compared factor VII administration in the intensive care unit with reoperation for refractory bleeding after complex cardiovascular surgery. From 1501 patients who underwent cardiovascular procedures between December 2003 and September 2007, 415 high-risk patients were identified. From this cohort, 24 patients were divided into 2 groups based on whether they either received factor VII in the intensive care unit (n=12) or underwent reoperation (n=12) for refractory bleeding. Preoperative and postoperative data were collected to compare efficacy, safety, and economic outcomes. In-hospital survival for both groups was 100%. Factor VII was comparable with reoperation in achieving hemostasis, with both groups demonstrating decreases in chest tube output and need for blood products. Freedom from reoperation was achieved in 75% of patients receiving factor VII, whereas reoperation was effective in achieving hemostasis alone in 83.3% of patients. Prothrombin time, international normalized ratio, and median operating room time were significantly less (P<.05) in patients who received factor VII. Both groups had no statistically significant differences in other efficacy, safety, or economic outcomes. Factor VII administration in the intensive care unit appears comparable with reoperation for refractory bleeding after complex cardiovascular surgical procedures and might represent an alternative to reoperation in selected patients. Future prospective, randomized controlled trials might further define its role.

Cell saving systems do not reduce the need of transfusion in low-risk patients undergoing cardiac surgery

Cell saving systems have been widely used to reduce blood loss and need of transfusions. These device are mainly indicated in complex cardiac surgery procedures and in those patients with a high risk of bleeding. However, it is not clear if there is a benefit of a cell saver (CS) system in low-risk patients undergoing cardiac surgery. Our aim was to analyze if the use of CS systems reduce the need of blood products in low-risk patients undergoing cardiac surgery. Between February and June 2009 all low-risk patients (EuroSCORE<10%) undergoing coronary or valve procedure were selected (n=63). Exclusion criteria were: combined procedure, aorta procedure, redo surgery, emergency procedures, creatinine levels>2 mg/ml, anemic patients and patients with a body surface area (BSA)<1.6 m2. Patients were randomized to undergo cardiac surgery with a cell saving system (group CS) (n=34) or without (control group, CO) (n=29). All patients received tranexamic acid during the procedure. Need of blood products and clinical outcomes were analyzed in both groups. Mean age was 64.7±12.3 years old with 33% of female patients. Baseline clinical characteristics and preoperative blood count cell were similar in both groups. Mean CS blood reinfused was 461±174 ml (maximum: 985 minimum: 259). A total of 59 red blood packages were transfused in 25 patients (mean 1.02±1.3; range: 0-5). The proportion of patients being transfused was similar in both groups (CS: 40% vs. CO: 46.4%; P=0.79). Eleven plasma packages were transfused (CS: 8 vs. CO: 3; P=0.77) and three platelet pools were used in group CS and none in group CO (P=0.08). Multivariate analysis showed that preoperative hemoglobin levels>13.3 g/dl [relative risk (RR): 0.29; confidence interval (CI): 0.09-0.99] and BSA>1.74 (RR: 0.19; CI: 0.54-0.68) were protective against blood transfusion. In low-risk patients CS system did not reduce the need of blood transfusion. Clinical outcomes were similar regardless of the use of a cell saver system. A low preoperative hemoglobin level and a low BSA were related with the use of blood products.

The need for blood products in patients with crush syndrome

Crush syndrome is typical for multisystem involvement because of coexisting major surgical and/or medical problems. Treatment of patients with crush syndrome following mass disasters is even more problematic as hundreds of patients are admitted to hospitals and need therapy at once. In this study, the authors evaluated the need of blood and blood products in patients hospitalized due to crush syndrome after the Marmara earthquake in a single center The clinical and laboratory variables regarding 60 patients with crush syndrome (30 males and 30 females; mean age: 31.3 +/- 13.8 years) hospitalized at a tertiary center that were documented on the preformed questionnaires distributed by International Society of Nephrology Task Force at the aftermath of the earthquake were analyzed by Statistical Package for Social Sciences for Windows software version 13.0 (SPSS Inc, Chicago, IL, USA). Thirty-nine patients (16 males and 23 females; mean age: 30.1 +/- 12.6 years) were transfused with 589 U of blood, 840 U of fresh frozen plasma, and 172 U of human albumin during the hospitalization. Most of the transfusions were performed during the first week after the hospitalization. As a result, the preparation for disasters should also include logistic plans for obtaining sufficient amount of blood and blood products to be used in the early aftermath of the event.

The usage of blood components in obstetrics

Major obstetric hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Even though blood transfusion may be a life-saving procedure, an inappropriate usage of blood products in obstetric emergencies especially in cases of massive bleeding is associated with increased morbidity and risk of death. Thorough knowledge of the etiology, pathophysiology, and optimal therapeutic options of major obstetric hemorrhage may help to avoid lethal outcomes. There are evidence-based data about some risks related with transfusion of blood components: acute or delayed hemolytic, febrile, allergic reactions, transfusion-related acute lung injury, negative immunomodulative effect, transmission of infectious diseases, dissemination of cancer. This is why the indications for allogeneic blood transfusion are restricted, and new safer methods are being discovered to decrease the requirement for it. Red cell alloimmunization may develop in pregnancy; therefore, all pregnant women should pass screening for irregular antibodies. Antierythrocytic irregular antibodies may occur due to previous pregnancies or allogeneic red blood cell transfusions, and it is important for blood cross-matching in the future. Under certain circumstances, such as complicated maternal history, severe coagulation abnormalities, severe anemia, the preparation of cross-matched blood is necessary. There is evidence of very significant variation in the use of blood products (red cells, platelets, fresh frozen plasma, or cryoprecipitate) among clinicians in various medical institutions, and sometimes indications for transfusion are not correctly motivated. The transfusion of each single blood product must be performed only in case of evaluation of expected effect. The need for blood products and for their combination is necessary to estimate for each patient individually in case of obstetric emergencies either. Indications for transfusion of blood components in obstetrics are presented in order to improve the skills of doctors and to optimize therapeutic options in obstetric emergencies.

Psychological and behavioural impacts of the 2008 China earthquake on blood donors

On May 12, 2008, a severe earthquake hit Sichuan province in China. A post-earthquake survey was conducted to study the earthquake's effect on blood donor behaviour and stress at three blood centres at varying distances from the epicentre. A questionnaire was developed to assess donor post-traumatic stress disorders (PTSD) and attitudes toward giving blood. Responses were compared by centre and donor characteristics using multivariate logistic regression techniques. Of all 17 456 donors, the overall prevalence of PTSD was 13.2%. Donors who knew someone killed or injured by the earthquake were 2.1 times more likely to have PTSD than others (95% CI: 1.8-2.4). 85.2% of donors cited the earthquake as their reason for donating. 16.1% of donors felt it acceptable to be less honest about one's health history in an emergency. After adjusting for PTSD, geographic and demographic characteristics, the donors knowing someone killed or injured by the earthquake were 1.4 times (95% CI: 1.2-1.7) more likely to cite the earthquake as reason for donating, and 1.8 times (95% CI: 1.5-2.1) more likely to accept being less honest about one's health history in case of national emergency. The psychological and behavioural impacts of the earthquake on blood donors extended far from the epicentre. After a disaster, it is important to emphasize that donors must be truthful on the donor questionnaire as some donors appear willing to be less than honest when they perceive an increased need for blood products.

The Extended Surgical Time-Out: Does It Improve Quality and Prevent Wrong-Site Surgery?

To review the initial results of implementing an extended surgical time-out (STO) in pediatric surgery.Starting in January 2006, all members of our surgical team implemented and used an extended STO, confirming the patient's identity, technical and anesthetic details, administered and available medications, and need for blood products and special equipment. To avoid disrupting work flow, the STO was initially after anesthesia induction. Starting in October 2007, the STO was done before anesthesia induction. Initial results, elapsed time to incision, and surgical team surveys were reviewed before and after implementing the preinduction STO.The elapsed time to incision was similar for elective and urgent operations before and after implementing the preinduction STO. All antibiotics were administered and confirmed during the STO. Four significant equipment findings were detected, altering the planned procedure (two before and two after implementing the preinduction STO). Operating room staff felt more confident and prepared for the operations because communication was improved. One near-miss occurred during the postinduction STO. One wrong-site operation occurred despite the preinduction STO, because of inadequate marking. Root-cause analysis demonstrated that this was due to a systems error.Using the extended STO before anesthesia induction improved communication among the surgical team members and did not disrupt work flow. An extended STO may also have broader value, such as confirming timely antibiotic administration or meeting other quality measures. The extended STO did not eliminate wrong-site surgery. However, implementation of the STO placed the responsibility for wrong-site surgery with the whole team and system, rather than with the individual surgeon.

Ten‐minute chat

Jenny Walton qualified from Edinburgh in 1998. After the birth of her first daughter in 2002, she worked nights for Vets Now, and saw a need for blood products in the emergency and critical care field. As a result, she ran a pilot trial on canine blood banking in the north‐east of England, and has been veterinary supervisor for Pet Blood Bank UK since the charity's launch in 2007

Somatostatin Analogues in the Treatment of Recurrent Bleeding from Gastrointestinal Vascular Malformations: An Overview and Systematic Review of Prospective Observational Studies

Vascular malformation of the gastrointestinal tract is an uncommon cause for gastrointestinal bleeding. Traditionally, gastroenterologists prefer to use endoscopic modalities like argon plasma coagulation and electrocoagulation to treat accessible lesions. The role of somatostatin analogues (octreotide) in preventing recurrent bleeding in these patients is unclear. The use of pharmacological treatments would be useful especially in refractory bleeding, inaccessible lesions and in patients who are at high risk for invasive interventions. To systematically review pooled clinical response rates from prospective studies using somatostatin analogues for prevention of recurrent bleeding from gastrointestinal angiodysplasia and quantify the effects that therapy has on the use of blood transfusions. We searched several electronic databases including Pubmed for full journal articles published after 1966 reporting on the use of somatostatin analogues in the treatment of gastrointestinal angiodyplasia. We hand searched the reference lists of all retrieved articles. Prospective studies involving ten or more patients were included in the analysis. We calculated the pooled proportion of patients who had a clinical response to therapy in the selected studies and the weighted mean difference in transfusion requirements before and after therapy. Heterogeneity between the studies was assessed using the I2 statistic. A total of three studies involving 62 patients met the inclusion criteria. The proportional meta-analysis showed a clinical response to treatment of 0.76 (95% CI 0.64-0.85). The weighted mean difference in transfusion requirements before starting therapy (control group) and after treatment initiation (treatment group) was -2.2 (95% CI -3.9 to -0.5). No significant heterogeneity was seen between the studies. A significant number of patients with bleeding gastrointestinal angiodysplasia respond to treatment with octreotide by reducing the need for blood products. As all the included studies had small sample sizes, multicenter randomized trials are needed to confirm these findings. However, it seems reasonable to administer octreotide especially in patients with refractory bleeding, inaccessible lesions and in patients at high risk for other interventions.

The Extended Surgical Time-Out: Does It Improve Quality and Prevent Wrong-Site Surgery?

To review the initial results of implementing an extended surgical time-out (STO) in pediatric surgery. Starting in January 2006, all members of our surgical team implemented and used an extended STO, confirming the patient's identity, technical and anesthetic details, administered and available medications, and need for blood products and special equipment. To avoid disrupting work flow, the STO was initially after anesthesia induction. Starting in October 2007, the STO was done before anesthesia induction. Initial results, elapsed time to incision, and surgical team surveys were reviewed before and after implementing the preinduction STO. The elapsed time to incision was similar for elective and urgent operations before and after implementing the preinduction STO. All antibiotics were administered and confirmed during the STO. Four significant equipment findings were detected, altering the planned procedure (two before and two after implementing the preinduction STO). Operating room staff felt more confident and prepared for the operations because communication was improved. One near-miss occurred during the postinduction STO. One wrong-site operation occurred despite the preinduction STO, because of inadequate marking. Root-cause analysis demonstrated that this was due to a systems error. Using the extended STO before anesthesia induction improved communication among the surgical team members and did not disrupt work flow. An extended STO may also have broader value, such as confirming timely antibiotic administration or meeting other quality measures. The extended STO did not eliminate wrong-site surgery. However, implementation of the STO placed the responsibility for wrong-site surgery with the whole team and system, rather than with the individual surgeon.

The ‘normobaric oxygen paradox’: a simple way to induce endogenous erythropoietin production and concomitantly raise hemoglobin levels in anemic patients

Dear Sir, There is increasing concern regarding the inherent hazard of blood transfusions, host–graft reactions and transfusion-related acute lung injury. Considering the increasing population age, the increased need for blood products when reaching older age, and an already chronic shortage of blood products today, the need for alternative techniques to blood transfusion, and for new blood substitutes or blood salvage techniques is becoming more and more pressing. The use of blood cell progenitor enhancers like exogenous erythropoietin (EPO) is extensively recognized, and in patients with appropriate medical followup, a relatively low rate of adverse effects has been reported. However, the price of such medications is very high and in some countries, their availability is limited. A recently described phenomenon called the ‘normobaric oxygen paradox’ (NOP) may have clinical applications. The technique consists in a simple administration of high oxygen concentration to spontaneously breathing subjects. This has been shown to trigger a Transfusion Alternatives in Transfusion Medicine TATM

Plasma sequestration: a good therapy to prevent the deleterious effect of clopidogrel when clopidogrel is used within one to four days of coronary bypass surgery

Clopidogrel (Plavix) is an inhibitor of ADP-induced platelet aggregation, acting by direct inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADP-mediated activation of the glycoprotein GPIIb/IIIa complex. A common recommendation for coronary artery bypass surgery is to stop clopidogrel five to seven days before surgery.(1) Patients taking clopidogrel within five days of surgery are more likely to show an increase in post-operative bleeding, an increase need for blood products, and an increased chance for secondary operations to control bleeding. This paper presents an option which appears to decrease the adverse effects of clopidogrel for patients undergoing coronary artery bypass surgery within one to four days of stopping the use of clopidogrel. This option is autologous plasma sequestration. The process of plasma sequestration collection prior to the administration of heparin during surgery offers a significant therapy to minimize bleeding post bypass. Twelve consecutive patients are included in this study (one a REDO) each receiving clopidogrel within one to four days of surgery. Throughout their hospital stay, three patients required packed red blood cell (RBC) transfusions (two received 2 units, one received 1 unit). No other donor blood products were required. Post-operative bleeding was minimal, and the need for a secondary operation due to bleeding was eliminated. The average stay in the cardiovascular intensive care unit(CICU) was 2.8 days, with an average hospital stay of 7.25 days.

Comparison of minimally invasive closed circuit versus standard extracorporeal circulation for aortic valve replacement: a randomized study☆

To evaluate the clinical results of aortic valve replacement performed with a miniaturized closed circuit extracorporeal circulation (MECC) system and to compare it to standard cardiopulmonary bypass (CPB). One hundred and twenty consecutive patients undergoing isolated aortic valve replacement were randomly assigned to either a miniaturized closed circuit CPB with the maquet-cardiopulmonary MECC System (study group, n=60) or to a standard CPB (control group, n=60). Demographic characteristic and operative data were similar in the two groups. No hospital death occurred in either group and no difference in intensive care unit (ICU) stay and in-hospital stay was observed. Patients in the study group showed lower chest tube drainage (212+/-62 ml vs. 420+/-219 ml, P<0.05) and lower need for blood products (6.1% vs. 40.4%, P<0.05) than patients in the control group. Platelet count at ICU arrival was significantly higher in the study group (139+/-40 x 10(9)/l vs. 164+/-75 x 10(9)/l, P=0.05). Peak postoperative troponin I release was significantly lower in the MECC group (3.81+/-2.7 ng/dl vs. 6.6+/-6.8 ng/dl, P<0.05). In this randomized study the MECC system has demonstrated best postoperative clinical results in terms of need for transfusion, platelets consumption and myocardial damage as compared to standard CPB.

Evaluation of air handling in a new generation neonatal oxygenator with integral arterial filter

Prime volume of the cardiopulmonary bypass circuit may lead to significant hemodilution and the potential need for blood products for all patients, but may be more critical in the pediatric and, specifically, the neonatal patient. We report on the first use of the Terumo CAPIOX FX05 (Baby-FX) oxygenator with integral arterial filter, prime volume 43 ml, evaluating performance and air-handling of six Baby-FX versus thirteen Baby-RX oxygenators. The Terumo Baby-FX primes and performs as easily as the Baby-RX series. A significant prime component in the neonatal CPB circuit can be the arterial line filter (ALF). Removal of the ALF may lead to significant reduction in prime volume, decreased exposure to foreign surfaces with subsequent reduction in inflammation, and potential elimination or reduction in blood product exposures.

Colonoscopy polypectomy management in Glanzmann’s thrombasthenia

Glanzmann's thrombasthenia (GT) is a rare autosomal recessive bleeding syndrome characterized by abnormal Glycoprotein IIb/IIIa complex (GIIb/IIIa) on platelets with resultant abnormality in platelet aggregation. There is very little information regarding polypectomy management in GT. We report a single patient with this rare disease, who underwent sequential endoscopic management of large colon polyps. Polypectomy in our GT patient was complicated by immediate and delayed bleeding. Multiple clips used after standard cautery polypectomy for a polyp 10 mm or larger in our GT patient, was most effective in preventing immediate and delayed post-polypectomy bleeding than other known therapeutic approaches. We favor preemptive use of multiple clips in large polypectomy defects for GT patients and we may argue the added cost may be offset by the reduction in the need for blood products, and by averting or shortening potential hospitalizations.

The use of recombinant activated factor VII for blood loss after cardiovascular surgery

To describe the early experiences with rFVIIa in the management of bleeding after cardiovascular surgery. From May 2006 through December 2007, 16 patients received rFVIIa during or after surgery despite conventional medical therapy and transfusion of blood products. There were 15 male patients and 1 female patients, aged from 36 to 77 years old with a mean of 52 years old. The surgical procedures include aortic procedures for 8 cases, valve replacement for 6 cases, pulmonary thromboendarterectomy for 1 case and atrial septal defect repair for 1 case. The data of these patients were reviewed and the safety and efficacy of rFVIIa after cardiovascular surgery were evaluated. rFVIIa was administered as a first dose of 27.6 to 54.5 microg/kg with a mean of 40.2 microg/kg. Six patients achieved hemostasis after the first dose. Nine patients received a second administration within 30 min, with a cumulative dose of 59.3 to 90.9 microg/kg, a mean of 80.3 microg/kg. Eight patients achieved hemostasis and 1 patient went to exploration. One patient received four doses of rFVIIa with a cumulative dose of 203.4 microg/kg and the bleeding stopped. Mean amount of chest drain loss and the amount of red blood cell, fresh frozen plasma, cryoprecipitate, and platelet transfusions decreased significantly after rFVIIa administration. The total amount of chest drain losses, transfusions of red blood cell and cryoprecipitate within 12 h postoperatively was positively correlated with the time from the end of bypass to administration of rFVIIa. No thromboembolic complications and other adverse reactions were noted. The use of rFVIIa is associated with reduced blood loss, rapid improvement of coagulation variables, and decreased need for blood products. rFVIIa is safe and efficacious in the management of refractory postcardiotomy bleeding.

Colonoscopic Polypectomy in Glanzmannʼs Thrombasthenia

Purpose: Glanzmann's thrombasthenia (GT) is a rare autosomal recessive bleeding syndrome characterized by absent platelet aggregation secondary to abnormal Glycoprotein IIb/IIIa complex. We report the first case of endoscopic management of large polyps in a patient with GT. Methods: A 52-year-old African American female with GT underwent four sequential colonoscopies over 9 months as enumerated below. Results: Colonoscopy 1: Performed for heme-positive stools, no blood products given. It revealed multiple sessile polyps, the 2 largest (13 and 14 mm) in the right colon. The 13 mm one was removed using saline-assisted technique in combination with Endoloop and standard cautery. Immediate post-polypectomy bleeding was observed and successfully controlled with placement of 2 Triclips. Further polypectomies were deferred. The polyp was a sessile serrated adenoma. A surgical opinion recommended endoscopic surveillance. Colonoscopy 2: Preprocedure platelets and aminocaproic acid were given. Hot biopsy polypectomies were done to remove ten smaller 4–5 mm polyps in left colon. The 14 mm polyp was left in place to help localize potential post-polypectomy bleeding. No immediate or delayed bleeding occurred. Colonoscopy 3: Preprocedure platelets and aminocaproic acid were given. The remaining 14 mm polyp was removed by saline-assisted technique. A single Quick Clip placed at the polypectomy site. Two other smaller polyps (7 and 9 mm) were also removed from the left colon using standard electrocautery, with no clips applied. Three days later patient was admitted with delayed post-polypectomy bleeding. Colonoscopy 4: Hematochezia persisted despite daily replacement of red blood cells, platelets, recombinant factor VIIa, and prothrombin concentrate complex over a period of 10 days prompted the fourth colonoscopy. Active bleeding was identified in the right colon at the 14 mm polypectomy site. Dual therapy with epinephrine injection and placement of 4 Resolution clips achieved hemostasis. No further episodes of colonic bleeding have been reported to date. Conclusion: Polypectomy in GT patients is complicated by immediate and delayed bleeding. The single previous GT case report suggested a protective effect of platelet transfusion and aminocaproic acid, to retard fibrinolysis, in preventing post-polypectomy bleeding. However, we conclude that for polyps 10 mm or larger the addition of mechanical therapy, with multiple clips, after standard cautery polypectomy, is more effective in preventing immediate and delayed post-polypectomy bleeding in patients with GT. The cost of preemptive multiple clips at the post-polypectomy site may be offset by a reduction in the need for blood products and by averting or shortening potential hospitalizations.

Postpartum Dexamethasone for Women With Hemolysis, Elevated Liver Enzymes, and Low Platelets (HELLP) Syndrome: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

A combination of hemolysis, elevated liver enzymes, and low platelets—the HELLP syndrome—is one of the most severe forms of preeclampsia and one for which no definitive treatment is available. The use of corticosteroids has been proposed because of their ability to reduce platelet adhesion, limit platelet removal by the spleen, activate platelets, and exert a direct effect on the endothelium. In this prospective, randomized, double-blind, placebo-controlled trial,105 women with HELLP syndrome in the postpartum period were assigned to receive either 10 mg of dexamethasone or placebo solution by intravenous injection every 12 hours over 4 days. In addition, all patients received magnesium sulfate to prevent or treat eclamptic convulsions, and captopril to control hypertensive peaks exceeding 180 mm Hg systolic and/or 120 mm Hg diastolic. Baseline characteristics were similar in the 56 women given dexamethasone and the 49 receiving placebo. Complication rates also were similar in the 2 groups. Oliguria was the most frequent complication, followed by hemorrhage at a variety of sites. Acute renal failure occurred in 16% of steroid-treated women and 24.5% of the control group. The respective figures for acute pulmonary edema were 3.6% and 10.2%. No significant differences in either maternal morbidity or mortality were observed. Two steroid-treated patients (3.6%) and 2 placebo recipients (4.1%) died. The groups also were comparable with respect to time in hospital and the need for blood products. There were no significant group differences in the pattern of platelet recovery, levels of aspartate aminotransferase or lactate dehydrogenase, hemoglobin, or diuresis. The investigators conclude that these findings fail to support the routine use of dexamethasone following childbirth in women with HELLP syndrome.

Use of propofol for anesthesia in cats with primary hepatic lipidosis: 44 cases (1995–2004)

OBJECTIVE-To determine morbidity and fatalities in cats with hepatic lipidosis that received propofol to facilitate placement of a feeding tube. STUDY DESIGN-Retrospective case series. ANIMALS-44 Cats with presumed primary hepatic lipidosis anesthetized for placement of a feeding tube. PROCEDURES-Medical records from January 1995 through December 2004 were reviewed to identify cats that matched the inclusion criteria (histologic confirmation of hepatic lipidosis, anesthetized for placement of feeding tube, complete intensive care unit [ICU] records, and recorded outcome). Data extracted included age, body weight, sex, anesthetic drugs, drug dosages, type of feeding tube, duration of anesthesia, number of hours in ICU, administration of blood products, and survival until discharge from ICU. RESULTS-44 Cats (21 females and 23 males) were included in the analysis. Age range was 3 to 15 years (median, 8 years), and body weight ranged from 1.8 to 9.0 kg (4.0 to 19.8 lb), with a median of 4.8 kg (10.6 lb). Twenty-seven cats were administered propofol. There was no significant association between the use of propofol or the dosage of propofol and any risk factor, need for blood products, number of hours in the ICU, or survival. There was no significant difference between cats that received propofol and cats that did not receive propofol with regard to interval until discharge from the ICU. CONCLUSIONS AND CLINICAL RELEVANCE-The use of propofol did not increase morbidity or fatalities in cats with primary hepatic lipidosis. Thus, propofol can be used in these cats for placement of a feeding tube.