Desmopressin acetate is a mild vasodilator that does not reduce blood loss in uncomplicated cardiac surgical procedures.
Desmopressin acetate (DA) is a synthetic analog of vasopressin that may improve perioperative coagulation in cardiac surgical patients. Twenty-seven adult patients with good left ventricular function and normal preoperative coagulation profiles scheduled to undergo elective cardiac surgery participated in the double-blinded, placebo-controlled study. The 14 patients in the DA group received the drug over 10 minutes (starting 15 minutes after protamine administration). The 13 patients in the placebo group received an equal volume of saline. Preoperative template bleeding time was longer in the placebo group (P = 0.04). Otherwise, there were no statistically significant differences between the groups in demographics, coagulation variables, renal concentrating function, blood loss, or transfusion requirements at any study interval. The only significant hemodynamic differences detected were an increase in cardiac output in the DA group and a corresponding decrease in systemic vascular resistance. Five of 13 patients who received DA required treatment for hypotension, whereas none of 12 patients who received placebo required treatment during the infusion (P = 0.008). The authors conclude that DA causes mild vasodilation, but does not reduce blood loss or transfusion requirements in patients undergoing primary uncomplicated cardiac surgical procedures.
Reich
D L
DL
Department of Anesthesiology, Mount Sinai Medical Center, New York, NY 10029-6574.
Hammerschlag
B C
BC
Rand
J H
JH
Weiss-Bloom
L
L
Perucho
H
H
Galla
J
J
Thys
D M
DM
D000771:Anesthesia, Intravenous; D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001794:Blood Pressure / Q000187:drug effects; D001803:Blood Transfusion; D002302:Cardiac Output / Q000187:drug effects; D002306:Cardiac Volume / Q000187:drug effects; D002315:Cardiopulmonary Bypass / Q000379:methods; D001026:Coronary Artery Bypass; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006351:Heart Valves / Q000601:surgery*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects; D016278:Ventricular Function, Right / Q000187:drug effects
D010919:Placebos; D003894:Deamino Arginine Vasopressin