Desmopressin improves platelet activity in acute intracerebral hemorrhage.

Andrew M. Naidech, Matthew B. Maas, Kimberly E. Levasseur-Franklin, Eric M. Liotta, James C. Guth, Micheal Berman, Joshua M. Rosenow, Paul F. Lindholm, Bernard Bendok, Shyam Prabhakaran, Richard A. Bernstein, Hau C. Kwaan

Research output: Contribution to journalArticle

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Abstract

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. 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. 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. 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. http://www.clinicaltrials.gov. Unique identifier: NCT00961532.

Original languageEnglish (US)
Pages (from-to)2451-2453
Number of pages3
JournalStroke; a journal of cerebral circulation
Volume45
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Deamino Arginine Vasopressin
Cerebral Hemorrhage
Hematoma
Blood Platelets
von Willebrand Factor
Epinephrine
Growth
Platelet Transfusion
Hemostasis
Hypotension
Aspirin
Germany
Fever
Placebos

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Naidech, A. M., Maas, M. B., Levasseur-Franklin, K. E., Liotta, E. M., Guth, J. C., Berman, M., ... Kwaan, H. C. (2014). Desmopressin improves platelet activity in acute intracerebral hemorrhage. Stroke; a journal of cerebral circulation, 45(8), 2451-2453. https://doi.org/10.1161/STROKEAHA.114.006061

Desmopressin improves platelet activity in acute intracerebral hemorrhage. / Naidech, Andrew M.; Maas, Matthew B.; Levasseur-Franklin, Kimberly E.; Liotta, Eric M.; Guth, James C.; Berman, Micheal; Rosenow, Joshua M.; Lindholm, Paul F.; Bendok, Bernard; Prabhakaran, Shyam; Bernstein, Richard A.; Kwaan, Hau C.

In: Stroke; a journal of cerebral circulation, Vol. 45, No. 8, 2014, p. 2451-2453.

Research output: Contribution to journalArticle

Naidech, AM, Maas, MB, Levasseur-Franklin, KE, Liotta, EM, Guth, JC, Berman, M, Rosenow, JM, Lindholm, PF, Bendok, B, Prabhakaran, S, Bernstein, RA & Kwaan, HC 2014, 'Desmopressin improves platelet activity in acute intracerebral hemorrhage.', Stroke; a journal of cerebral circulation, vol. 45, no. 8, pp. 2451-2453. https://doi.org/10.1161/STROKEAHA.114.006061
Naidech, Andrew M. ; Maas, Matthew B. ; Levasseur-Franklin, Kimberly E. ; Liotta, Eric M. ; Guth, James C. ; Berman, Micheal ; Rosenow, Joshua M. ; Lindholm, Paul F. ; Bendok, Bernard ; Prabhakaran, Shyam ; Bernstein, Richard A. ; Kwaan, Hau C. / Desmopressin improves platelet activity in acute intracerebral hemorrhage. In: Stroke; a journal of cerebral circulation. 2014 ; Vol. 45, No. 8. pp. 2451-2453.
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abstract = "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. 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. 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. 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. http://www.clinicaltrials.gov. Unique identifier: NCT00961532.",
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