| The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty. | |
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MedLine Citation:
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PMID: 20546209 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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K A Leino; H K Pälve; H T Tiusanen; T T Tuppurainen |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2010-06-09 |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: 54 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-23 Completed Date: 2010-10-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
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Languages: eng Pagination: 863-70 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, Turku University Hospital, Turku, Finland. kari.leino@tyks.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Arthritis, Rheumatoid / blood, surgery* Arthroplasty, Replacement, Hip* Blood Loss, Surgical / prevention & control* Deamino Arginine Vasopressin / pharmacology* Double-Blind Method Endpoint Determination Erythrocyte Transfusion Female Hemoglobins / metabolism Humans Male Middle Aged Partial Thromboplastin Time Platelet Count Postoperative Complications / epidemiology Venous Thrombosis / complications, epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins; 16679-58-6/Deamino Arginine Vasopressin |
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