Document Detail


Desmopressin acetate following cardiopulmonary bypass: evaluation of coagulation parameters.
MedLine Citation:
PMID:  2521029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 microgram/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.
Authors:
M R Brown; T H Swygert; C W Whitten; R Hebeler
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiothoracic anesthesia     Volume:  3     ISSN:  0888-6296     ISO Abbreviation:  J Cardiothorac Anesth     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1992-08-18     Completed Date:  1992-08-18     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8709732     Medline TA:  J Cardiothorac Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  726-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Baylor University Medical Center, Dallas, TX 75246.
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation / drug effects*
Blood Platelets / drug effects
Cardiopulmonary Bypass*
Coronary Artery Bypass
Deamino Arginine Vasopressin / therapeutic use*
Double-Blind Method
Female
Hematocrit
Humans
Hypertension / etiology
Male
Middle Aged
Partial Thromboplastin Time
Placebos
Platelet Count / drug effects
Thrombelastography
Whole Blood Coagulation Time
Chemical
Reg. No./Substance:
0/Placebos; 16679-58-6/Deamino Arginine Vasopressin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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