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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 1417-1422, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
I Gratz, J Koehler, D Olsen, M Afshar, N DeCastro, PM Spagna, SG Ablaza and GE Larijani
It has been suggested that desmopressin acetate has been effective in
reducing hemorrhage after coronary artery bypass grafting in patients
receiving aspirin before operation. We conducted a prospective, randomized,
placebo-controlled, double-blind trial to determine the effectiveness and
safety of desmopressin in these patients. Sixty-five patients pretreated
with aspirin within 7 days before their scheduled elective coronary artery
bypass grafting were randomized to receive desmopressin (0.3 micrograms/kg)
or placebo after cessation of bypass and reversal of heparin with
protamine. The demographic characteristics and last dose of aspirin were
similar in both groups. There was a significant reduction in postoperative
blood loss noted between groups for both chest tube blood loss (833 +/- 311
ml for the 1-desamino-8-D- arginine vasopressin [desmopressin] group versus
1176 +/- 674 ml for the placebo group; p = 0.016) and total blood loss
(1215 +/- 381 ml for the desmopressin group versus 1637 +/- 761 ml for the
placebo group; p = 0.0097). Despite the differences in blood loss between
the two groups, the red cell transfusions were not significantly different,
but the use of platelets was less in the desmopressin group and almost
achieved statistical significance (p = 0.053). Neither was there a
difference in the occurrence of thrombotic complications between groups. It
appears that desmopressin in this specific subgroup of patients receiving
preoperative aspirin is effective as a prophylactic agent for reduction of
postsurgical hemorrhage.
ARTICLES
The effect of desmopressin acetate on postoperative hemorrhage in patients receiving aspirin therapy before coronary artery bypass operations
Department of Anesthesia, Medical College of Pennsylvania, Philadelphia 19129.
This article has been cited by other articles:
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  H. Pleym, R. Stenseth, A. Wahba, L. Bjella, A. Tromsdal, A. Karevold, and O. Dale Prophylactic Treatment with Desmopressin Does Not Reduce Postoperative Bleeding After Coronary Surgery in Patients Treated with Aspirin Before Surgery Anesth. Analg., March 1, 2004; 98(3): 578 - 584. [Abstract] [Full Text] [PDF]
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 N. J. Skubas and G. J. Despotis Optimal Management of Bleeding Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 217 - 228. [Abstract] [PDF]
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 G. J. Despotis and L. T. Goodnough Management approaches to platelet-related microvascular bleeding in cardiothoracic surgery Ann. Thorac. Surg., August 1, 2000; 70(2): S20 - 32. [Abstract] [Full Text] [PDF]
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 I. J Reece, G. H Linley, J. Tolia, J. Sheth, and H. Al Tareif Re-inventing the wheel: the use of autologous and fresh donor blood in cardiac surgery Perfusion, March 1, 1995; 10(2): 93 - 99. [Abstract] [PDF]
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S. E. Fremes, B. I. Wong, E. Lee, R. Mai, G. T. Christakis, R. F. McLean, B. S. Goldman, and C. D. Naylor Metaanalysis of prophylactic drug treatment in the prevention of postoperative bleeding Ann. Thorac. Surg., December 1, 1994; 58(6): 1580 - 1588. [Abstract] [PDF]
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S. Lethagen Desmopressin (DDAVP), tranexamic acid and haemostasis Perfusion, September 1, 1993; 8(5): 417 - 425. [Abstract] [PDF]
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