Heparin, DDAVP and the bleeding time.
The effect on the bleeding time of heparin, followed by an infusion with desmopressin (DDAVP) 0.3 micrograms/kg or placebo in a randomized, double-blind set-up, was investigated in 20 patients treated for acute venous thromboembolism. The bleeding time was on the average prolonged by 90% (95% confidence interval 46%-134%) after at least 1 day of treatment with heparin. At that point DDAVP shortened the bleeding time by 23% with a confidence interval of -35% to -11% whereas the effect of placebo was -2% with a confidence interval of -23% to +20%. There was also a shortening of the APTT after DDAVP but not after placebo. It is concluded that DDAVP induces a partial reversal of the effect of heparin on the bleeding time, and that DDAVP should be tried in case of hemorrhagic problems.
Schulman
S
S
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
Johnsson
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001760:Bleeding Time; D001777:Blood Coagulation / Q000187:drug effects*; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000494:pharmacology*; D006494:Heparin Antagonists; D006801:Humans; D008297:Male; D008875:Middle Aged
D006494:Heparin Antagonists; D006493:Heparin; D003894:Deamino Arginine Vasopressin