Document Detail

The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty.
MedLine Citation:
PMID:  20546209     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Blood loss is an important issue for patients with rheumatoid arthritis undergoing hip surgery. We hypothesised that intraoperative desmopressin treatment would result in a reduction in blood loss in rheumatoid patients undergoing total hip arthroplasty. METHODS: Seventy-five patients scheduled for elective total hip arthroplasty were randomised to three groups to receive 0.4 microg/kg desmopressin (D 0.4), 0.2 microg/kg desmopressin (D 0.2) or placebo intraoperatively in a double-blind fashion. Blood transfusions were based on calculated safe allowable blood loss and haemoglobin measurements (trigger 90 g/l, 5.59 mmol/l). The primary endpoint was the total blood loss measured till the end of the fourth post-operative day. Secondary endpoints included red cell transfusion requirements and haemoglobin. RESULTS: Total blood loss during the study period was not significantly different between the groups (D 0.4 1829 +/- 1068; D 0.2 2240 +/- 843 and placebo 2254 +/- 1040 ml; P= 0.50). The total amount of red cell transfusions was fewer in group D 0.4 (3.6 +/- 1.6 U) when compared with D 0.2 (4.4 +/- 1.7 U; P=0.009) and placebo (4.5 +/- 2.0 U; P= 0.011) groups. Haemoglobin concentration was lower in the placebo group in the first (5.42 +/- 1.16 vs. 5.98 +/- 0.47 mmol/l; P=0.033) and the second (6.28 +/- 0.66 vs. 6.69 +/- 0.47 mmol/l; P=0.033) post-operative mornings compared with group D 0.4. CONCLUSION: Despite a lack of difference in the primary outcome, total blood loss, intraoperative administration of 0.4 microg/kg desmopressin resulted in fewer total red cell transfusion requirements in rheumatoid patients undergoing total hip arthroplasty when compared with 0.2 microg/kg treatment and placebo.
K A Leino; H K Pälve; H T Tiusanen; T T Tuppurainen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-06-09
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  863-70     Citation Subset:  IM    
Department of Anaesthesiology, Turku University Hospital, Turku, Finland.
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MeSH Terms
Arthritis, Rheumatoid / blood,  surgery*
Arthroplasty, Replacement, Hip*
Blood Loss, Surgical / prevention & control*
Deamino Arginine Vasopressin / pharmacology*
Double-Blind Method
Endpoint Determination
Erythrocyte Transfusion
Hemoglobins / metabolism
Middle Aged
Partial Thromboplastin Time
Platelet Count
Postoperative Complications / epidemiology
Venous Thrombosis / complications,  epidemiology
Reg. No./Substance:
0/Hemoglobins; 16679-58-6/Deamino Arginine Vasopressin

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