Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study

J. Ansell, V. Klassen, R. Lew, S. Ball, M. Weinstein, T. VanderSalm, N. Okike, I. Gratz, J. Leslie, A. Roberts, N. Fleming, P. Salzman

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

The effectiveness of prophylactic desmopressin acetate in reducing hemorrhage after cardiopulmonary bypass operations is controversial. We conducted a prospective, randomized, placebo-controlled, double-blind trial to determine its effectiveness and safety in such patients. Eighty-three evaluable patients undergoing valvular heart operations were randomized to receive desmopressin (0.3 μg/kg) (41) or placebo (42) after cardiac bypass. Demographic characteristics were similar in both groups. There was no significant difference in total 24-hour blood loss between groups (desmopressin 1064.8 ± 647.1 ml versus placebo 844.4 ± 507.6 ml; p > 0.05), or in the requirement for red blood cell, platelet, or fresh frozen plasma transfusion, or for reexploration for control of hemorrhage. Neither was there a difference in the occurrence of thrombotic complications between groups. Analysis of factor VIII activity, von Willebrand factor, or von Willebrand factor multimers failed to show significant correlations with blood loss or differences between groups except for factor VIII activity, which was significantly higher in the desmopressin group 1 hour after operation than in the placebo group. A detailed comparative analysis of similar trials to determine the reasons for different outcomes suggests that desmopressin should not be used routinely as a prophylactic agent to reduce postsurgical hemorrhage, but that it may be beneficial when used in patients who already manifest excessive bleeding postoperatively.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume104
Issue number1
StatePublished - 1992
Externally publishedYes

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Deamino Arginine Vasopressin
Double-Blind Method
Placebos
Hemorrhage
Factor VIII
von Willebrand Factor
Cardiopulmonary Bypass
Blood Platelets
Erythrocytes
Demography
Safety

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Ansell, J., Klassen, V., Lew, R., Ball, S., Weinstein, M., VanderSalm, T., ... Salzman, P. (1992). Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study. Journal of Thoracic and Cardiovascular Surgery, 104(1), 117-123.

Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study. / Ansell, J.; Klassen, V.; Lew, R.; Ball, S.; Weinstein, M.; VanderSalm, T.; Okike, N.; Gratz, I.; Leslie, J.; Roberts, A.; Fleming, N.; Salzman, P.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 104, No. 1, 1992, p. 117-123.

Research output: Contribution to journalArticle

Ansell, J, Klassen, V, Lew, R, Ball, S, Weinstein, M, VanderSalm, T, Okike, N, Gratz, I, Leslie, J, Roberts, A, Fleming, N & Salzman, P 1992, 'Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study', Journal of Thoracic and Cardiovascular Surgery, vol. 104, no. 1, pp. 117-123.
Ansell, J. ; Klassen, V. ; Lew, R. ; Ball, S. ; Weinstein, M. ; VanderSalm, T. ; Okike, N. ; Gratz, I. ; Leslie, J. ; Roberts, A. ; Fleming, N. ; Salzman, P. / Does desmopressin acetate prophylaxis reduce blood loss after valvular heart operations? A randomized, double-blind study. In: Journal of Thoracic and Cardiovascular Surgery. 1992 ; Vol. 104, No. 1. pp. 117-123.
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