Document Detail


Desmopressin does not reduce bleeding and transfusion requirements in congenital heart operations.
MedLine Citation:
PMID:  11156096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Desmopressin (DDAVP) has been evaluated in many randomized clinical trials as a means to reduce blood loss and transfusion of allogeneic blood in cardiac operation requiring cardiopulmonary bypass. Desmopressin reduces blood loss in adult patients with excessive bleeding after cardiac operation. Its usefulness in patients undergoing complex congenital heart repair with cardiopulmonary bypass is unproved. METHODS: Sixty patients younger than 40 years of age scheduled for complex congenital heart operation (44 redo, 16 primary) were enrolled in this prospective, randomized, double-blind trial. Desmopressin 0.3 microg/kg or placebo was administered 10 minutes after protamine administration. Transfusion requirements and postoperative blood loss were recorded. Differences were analyzed using analysis of variance with a p value of 0.05 or less used to denote statistical significance. RESULTS: There were no differences in demographic or surgical characteristics between the DDAVP or placebo groups. There was no difference in blood loss and transfusion requirements between the DDAVP and placebo groups. During the intraoperative postinfusion time period, the median blood loss for redo patients was 343 versus 357 mL/m2 for placebo versus DDAVP, respectively, and for primary patients, the median blood loss was 277 versus 228 mL/m2. CONCLUSIONS: The prophylactic use of DDAVP to reduce excessive bleeding or transfusion requirements in patients undergoing complex congenital heart operations is not warranted.
Authors:
W C Oliver; P J Santrach; G K Danielson; G A Nuttall; D R Schroeder; M H Ereth
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  70     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-01-11     Completed Date:  2001-02-01     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1923-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Mayo Foundation, Rochester, Minnesota 55905, USA. oliver.william@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Coagulation Tests
Blood Loss, Surgical / physiopathology,  prevention & control*
Blood Transfusion*
Cardiopulmonary Bypass
Child
Child, Preschool
Deamino Arginine Vasopressin / administration & dosage*,  adverse effects
Double-Blind Method
Female
Heart Defects, Congenital / surgery*
Hemostasis, Surgical*
Humans
Infant
Male
Prospective Studies
Reoperation
Chemical
Reg. No./Substance:
16679-58-6/Deamino Arginine Vasopressin

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


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