Desmopressin acetate in uncomplicated coronary artery bypass surgery: a prospective randomized clinical trial.
Bleeding in coronary artery bypass procedures increases morbidity and exposes patients to the risks associated with blood transfusion. Desmopressin acetate (DDAVP), a synthetic vasopressin analogue, may limit bleeding during cardiac surgery. In a prospective randomized trial, the authors evaluated the ability of DDAVP to reduce perioperative bleeding during uncomplicated coronary bypass operations. Sixty-two patients who underwent coronary artery bypass grafting were randomized to receive intraoperatively either a placebo or DDAVP. Both groups were similar with respect to operative characteristics and preoperative hematologic profiles, von Willebrand factor levels increased postoperatively in both placebo (2.77 +/- 1.06 versus 2.17 +/- 1.51 U) and DDAVP groups (2.75 +/- 0.94 versus 1.80 +/- 0.88 U). Only the increase in the DDAVP groups was significant (p less than 0.001). There was no difference in total blood loss between the placebo (1826 +/- 849 ml) and DDAVP groups (1716 +/- 688 ml). Total red cell transfusions were similar in placebo (3.4 +/- 1.3 units of blood) and DDAVP groups (3.6 +/- 0.8 units). These results do not support the intraoperative use of DDAVP to reduce perioperative bleeding in routine coronary artery bypass surgery.
Cardiovascular & Thoracic Surgery Service, Division of Hematology Medical Oncology, Royal Victoria Hospital, McGill University, Montreal.
G S
GS
Hedderich
D J
DJ
Petsikas
B A
BA
Cooper
M
M
Leznoff
A J
AJ
Guerraty
N L
NL
Poirier
J F
JF
Symes
J E
JE
Morin
D001803:Blood Transfusion; D001026:Coronary Artery Bypass; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014841:von Willebrand Factor / Q000032:analysis / Q000187:drug effects
D014841:von Willebrand Factor; D003894:Deamino Arginine Vasopressin