title: Hemodynamic performance and histamine levels after desmopressin acetate administration following cardiopulmonary bypass in adult patients.
abstract: Sixteen patients undergoing cardiac surgical procedures were prospectively randomized into two groups to study the hemodynamic and histamine-releasing effects of desmopressin acetate (DDAVP) administration after cardiopulmonary bypass. Ten minutes after administration of protamine for reversal of heparin, DDAVP, 0.3 microgram/kg, was infused intravenously over 5 seconds in group 1, and the same dose of DDAVP was administered over 5 minutes as an infusion in group 2. There were no statistical differences between baseline values in groups 1 and 2. DDAVP decreased mean arterial pressure by 30% and 25% in groups 1 and 2 (69 +/- 5 mm Hg to 52 +/- 8 mm Hg, P less than 0.005, and 79 +/- 20 mm Hg to 55 +/- 8 mm Hg, P less than 0.005), respectively. The hypotension in both groups was related to decreases in systemic vascular resistance (1,616 +/- 262 dyne.s.cm-5 to 1,073 +/- 199 dyne.s.cm-5, P less than 0.005, and 1,850 +/- 541 dyne.s.cm-5 to 1,144 +/- 214 dyne.s.cm-5, P less than 0.005). Phenylephrine infusion successfully treated the DDAVP-induced hypotension in all patients. Arterial histamine levels at 3 and 5 minutes after infusion of DDAVP did not differ significantly from baseline values. It is concluded that DDAVP at 0.3 microgram/kg is a potent vasodilator when administered intravenously and that histamine is not involved in producing its hypotensive effects.
authors.affiliation: Division of Cardiothoracic Anesthesiology, Medical College of Pennsylvania, Allegheny Campus.
authors.forename: J S
authors.initials: JS
authors.lastname: Jahr
authors.forename: J
authors.initials: J
authors.lastname: Marquez
authors.forename: E
authors.initials: E
authors.lastname: Cottington
authors.forename: D R
authors.initials: DR
authors.lastname: Cook
mesh_terms: D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D002496:Central Venous Pressure / Q000187:drug effects; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006632:Histamine / Q000097:blood*; D006801:Humans; D007022:Hypotension / Q000503:physiopathology / Q000517:prevention & control; D007262:Infusions, Intravenous; D010656:Phenylephrine / Q000627:therapeutic use; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D010656:Phenylephrine; D006632:Histamine; D003894:Deamino Arginine Vasopressin