Desmopressin acetate following cardiopulmonary bypass: Evaluation of coagulation parameters

Marc R. Brown, Thomas H. Swygert, Charles W. Whitten, Robert Hebeler

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Desmopressin acetate (DDAVP) has been advocated as efficacious in reducing mediastinal bleeding following cardiopulmonary bypass (CPB), and has been shown to ameliorate platelet dysfunction; however, this has not been evaluated during routine coronary artery bypass grafting (CABG). In the present study, this therapy was evaluated utilizing the thromboelastograph (TEG), a rapid, on-line means of diagnosing a coagulopathy. During elective CABG, 20 patients received either DDAVP, 0.3 μg/kg, intravenously, following heparin reversal after CPB, or a placebo infusion, in a randomized, double-blind fashion. Hemostasis was monitored with both the TEG and conventional coagulation tests. No significant differences between the two groups were found at induction, postprotamine, post-"study infusion," or 2 hours postoperatively, with the exception of the postoperative PTT (31.1 ± 3.2 v 36.5 ± 5.9 seconds for DDAVP v placebo, P = 0.03.) Total blood products transfused intraoperatively, and in the first 8, 16, 24, or 48 postoperative hours, were also similar between the groups. No manifestations of hypercoagulability were seen, but hypotension during the infusion was noted in four patients receiving DDAVP, and in none of the controls. It is concluded that the expense and potential complications of DDAVP therapy do not justify its routine use in CABG.

Original languageEnglish (US)
Pages (from-to)726-729
Number of pages4
JournalJournal of Cardiothoracic Anesthesia
Volume3
Issue number6
DOIs
StatePublished - 1989

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Deamino Arginine Vasopressin
Cardiopulmonary Bypass
Coronary Artery Bypass
Placebos
Thrombophilia
Hemostasis
Hypotension
Heparin
Blood Platelets
Hemorrhage
Therapeutics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Desmopressin acetate following cardiopulmonary bypass : Evaluation of coagulation parameters. / Brown, Marc R.; Swygert, Thomas H.; Whitten, Charles W.; Hebeler, Robert.

In: Journal of Cardiothoracic Anesthesia, Vol. 3, No. 6, 1989, p. 726-729.

Research output: Contribution to journalArticle

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