title: The Effect of Desmopressin on the Amount of Bleeding in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Cardiopulmonary Bypass Pump After Taking Anti-Platelet Medicine.
abstract: BACKGROUND
  Coronary artery bypass grafting (CABG) is a common surgical intervention at the end-stages of coronary artery occlusion disease. Despite the effectiveness of CABG, it may have particular complications, such as bleeding during and after surgery. So far, there have been many drugs used to reduce bleeding.
  
  
  OBJECTIVE
  This study aimed at investigating the effects of desmopressin on the amount of bleeding in patients undergoing CABG with a cardiopulmonary bypass pump (CPBP) who were taking anti-platelet medicine.
  
  
  METHODS
  One hundred patients scheduled for elective CABG with a CPBP were included in a prospective, placebo-controlled, double-blinded clinical trial study. They were randomly divided into two groups. One group received desmopressin (40 μg) and the other group received a placebo (isotonic saline). Seven patients were excluded from the study, and 47 and 46 patients participated in the desmopressin and control groups, respectively. The methods of monitoring and the anesthetic techniques were similar in both groups, and all surgeries were performed by one surgeon. Variables including age, gender, pump time, aortic clamp time, duration of surgery, complications (e.g., nausea and vomiting, blood pressure changes), the necessity to receive blood products, and coagulation tests (prothrombin time, partial thromboplastin time, international normalized ratio, and bleeding time) were assessed. Data were statistically analyzed with SPSS software version 17.
  
  
  RESULTS
  There was no significant difference between the groups regarding age, gender, pump time, clamp time, duration of surgery, complications, and the changes in hemoglobin and coagulation test measurements (P > 0.05). No significant difference was noted between the groups regarding the rate of bleeding after surgery (359.3 ± 266.2 in group D vs. 406.3 ± 341.6 in group P (control group); P = 0.208). However, the platelet changes after surgery in both groups were significantly different. The analysis revealed that the rate of thrombocytopenia after surgery was higher in the control group (P = 0.012).
  
  
  CONCLUSIONS
  Our study showed that desmopressin could not reduce the amount of blood loss after CABG. Also, desmopressin did not have a significant effect on coagulation status. Therefore, based on the results of our study, it seems that the use of this medication cannot be a helpful for patients with any indication for CABG.
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mirmansoori
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Farnoush
authors.initials: F
authors.lastname: Farzi
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Sedighinejad
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Vali
authors.initials: V
authors.lastname: Imantalab
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mohammadzadeh
authors.affiliation: Department of Statistics, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Atrkar Roushan
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Ghazanfar Tehran
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Nemati
authors.affiliation: Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Dehghan
keywords: Bleeding; Coronary Artery Bypass graft; Desmopressin