Use of desmopressin acetate to reduce blood transfusion requirements during cardiac surgery in patients with acetylsalicylic-acid-induced platelet dysfunction.
OBJECTIVE
To determine whether desmopressin acetate (DDAVP) has the ability to reduce blood loss in patients with a known bleeding tendency.


METHODS
A randomized, double-blind, placebo controlled study.


METHODS
A university teaching hospital.


METHODS
Men under the age of 70 years who had taken acetylsalicylic acid within 7 days of scheduled coronary artery bypass surgery. Patients with an abnormal hematologic profile or a history of bleeding or who were receiving heparin or undergoing repeat coronary bypass surgery were excluded. Forty-four patients were randomized with restriction in blocks of 10; 20 received DDAVP and 24 received a placebo.


METHODS
Blood loss and blood transfusion requirements.


RESULTS
Patients treated with DDAVP lost significantly (p < 0.01) less blood than those receiving a placebo (1543 mL versus 2376 mL respectively). Nineteen patients had a blood loss of more than 2000 mL; 15 of these were in the placebo group. Significantly (p < 0.02) fewer patients receiving DDAVP required blood transfusion (9 versus 18).


CONCLUSIONS
DDAVP reduces blood loss during cardiac bypass surgery in patients who have taken acetylsalicylic acid within 7 days before operation.
Sheridan
D P
DP
Department of Medicine, University of Saskatchewan, Saskatoon.
Card
R T
RT
Pinilla
J C
JC
Harding
S M
SM
Thomson
D J
DJ
Gauthier
L
L
Drotar
D
D
D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001792:Blood Platelets / Q000187:drug effects; D001803:Blood Transfusion; D001810:Blood Volume; D001026:Coronary Artery Bypass; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged
D003894:Deamino Arginine Vasopressin; D001241:Aspirin