title: Desmopressin improves platelet activity in acute intracerebral hemorrhage.
abstract: OBJECTIVE
  Minimizing hematoma growth in high-risk patients is an attractive strategy to improve outcomes after intracerebral hemorrhage. We tested the hypothesis that desmopressin (DDAVP), which improves hemostasis through the release of von Willebrand factor, improves platelet activity after intracerebral hemorrhage.
  
  
  METHODS
  Patients with reduced platelet activity on point-of-care testing alone (5), known aspirin use alone (1), or both (8) received desmopressin 0.4 μg/kg IV. We measured Platelet Function Analyzer-epinephrine (Siemens AG, Germany) and von Willebrand factor antigen from baseline to 1 hour after infusion start and hematoma volume from the diagnostic to a follow-up computed tomographic scan.
  
  
  RESULTS
  We enrolled 14 patients with of mean age 66.8±14.6 years, 11 (85%) of whom were white and 8 (57%) were men. Mean Platelet Function Analyzer-epinephrine results shortened from 192±18 seconds pretreatment to 124±15 seconds (P=0.01) 1 hour later, indicating improved plate activity. von Willebrand factor antigen increased from 242±96% to 289±103% activity (P=0.004), indicating the expected increase in von Willebrand factor. Of 7 (50%) patients who received desmopressin within 12 hours of intracerebral hemorrhage symptom onset, changes in hematoma volume were modest, -0.5 (-1.4 to 8.4) mL and only 2 had hematoma growth. One patient had low blood pressure and another had a new fever within 6 hours of desmopressin administration.
  
  
  CONCLUSIONS
  Intravenous desmopressin was well tolerated and improved platelet activity after acute intracerebral hemorrhage. Larger studies are needed to determine its potential effects on reducing hematoma growth versus platelet transfusion or placebo.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00961532.
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.). a-naidech@northwestern.edu.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Naidech
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Maas
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Levasseur-Franklin
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Eric M
authors.initials: EM
authors.lastname: Liotta
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: James C
authors.initials: JC
authors.lastname: Guth
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Micheal
authors.initials: M
authors.lastname: Berman
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Rosenow
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Paul F
authors.initials: PF
authors.lastname: Lindholm
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Bernard R
authors.initials: BR
authors.lastname: Bendok
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Shyam
authors.initials: S
authors.lastname: Prabhakaran
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bernstein
authors.affiliation: From the Department of Neurology (A.M.N., M.B.M., E.M.L., J.C.G., M.B., S.P., R.A.B.), Department of Neurosurgery (J.M.R., B.R.B.), Department of Pathology (P.F.L.), and Department of Hematology (H.C.K.), Northwestern University, Chicago, IL; and Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL (K.E.L.-F.).
authors.forename: Hau C
authors.initials: HC
authors.lastname: Kwaan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000187:drug effects*; D002543:Cerebral Hemorrhage / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006490:Hemostatics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D014841:von Willebrand Factor / Q000276:immunology
chemical_list: D006490:Hemostatics; D014841:von Willebrand Factor; D003894:Deamino Arginine Vasopressin
keywords: blood platelets; cerebral hemorrhage; deamino arginine vasopressin