Comparison between nasal and intravenous desmopressin for the treatment of aminosalicylic acid-induced platelet dysfunction.
OBJECTIVE
The study was conducted to compare the standard intravenous route with the intranasal route of desmopressin application and to establish the best time for initiating treatment with desmopressin with the use of the Born test and the PFA 100-Analyzer for monitoring the therapeutic effect.


METHODS
Thirty healthy volunteers (ASA I) with no known bleeding disorder were randomly assigned to an intravenous or an intranasal group in a cross-over design fashion. After obtaining baseline values, the volunteers were given 500 mg aminosalicylic acid for 3 days. On day 4, platelet function tests were performed and desmopressin (0.3 microg kg(-1) body weight) was administered either intravenously or intranasally. Born tests (aggregation after stimulation with epinephrine and collagen) were conducted at 30 and 240 min, and PFA 100 bleeding time measurements were conducted at 30, 120 and 240 min after desmopressin administration. Wilcoxon signed rank sum tests or non-parametric ANOVA for repeated measures were used for statistical evaluation.


RESULTS
All volunteers showed a marked decreased platelet function in the Born test (especially if stimulation with epinephrine was used) and an increased PFA 100 bleeding time after treatment with aminosalicylic acid. Platelet function was improved by intravenous as well as intranasal application of desmopressin (P < 0.001) after 30 min. The effect diminished after 4 h in both groups.


CONCLUSIONS
Intravenous as well as intranasal desmopressin improved platelet function in healthy volunteers with aminosalicylic acid-induced platelet dysfunction at least 30 min after application. The effect lasts up to 4 h.
Schulz-Stübner
S
S
Klinik für Anästhesiologie am Universitätsklinikum der RWTH Aachen, Germany. Schust@t-online.de
Zielske
D
D
Rossaint
R
R
D000281:Administration, Intranasal; D000636:Aminosalicylic Acids / Q000009:adverse effects*; D000704:Analysis of Variance; D001760:Bleeding Time; D001792:Blood Platelets / Q000187:drug effects*; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D013921:Thrombocytopenia / Q000139:chemically induced / Q000188:drug therapy*
D000636:Aminosalicylic Acids; D006490:Hemostatics; D003894:Deamino Arginine Vasopressin