PURPOSE: To determine the effects of desmopressin on coagulation and blood loss in patients undergoing elective partial hepatectomy. METHODS: A randomized, controlled and double-blind study on 59 patients who received either 0.3 micro g x kg(-1) ofdesmopressin or an equal volume of normal saline (control) infused intravenously over 20 min after induction of general anesthesia. RESULTS: There was an increase in plasma levels of factors VIII and von Willebrand after the infusion of study drug in both groups (P < 0.001). The activated partial thromboplastin time was shortened in Group D whereas prothrombin time was prolonged in Group C; (P = 0.02). A large range of intraoperative blood loss (400-7128 mL) was observed, with no significant differences between groups. There were no changes in plasma electrolyte levels or osmolality. Transfusion requirements were similar in both groups. CONCLUSION:Desmopressin did not reduce intraoperative blood loss or transfusion requirements during hepatectomy despite raising clotting factor levels and improving tests of hemostasis.
RCT Entities:
PURPOSE: To determine the effects of desmopressin on coagulation and blood loss in patients undergoing elective partial hepatectomy. METHODS: A randomized, controlled and double-blind study on 59 patients who received either 0.3 micro g x kg(-1) of desmopressin or an equal volume of normal saline (control) infused intravenously over 20 min after induction of general anesthesia. RESULTS: There was an increase in plasma levels of factors VIII and von Willebrand after the infusion of study drug in both groups (P < 0.001). The activated partial thromboplastin time was shortened in Group D whereas prothrombin time was prolonged in Group C; (P = 0.02). A large range of intraoperative blood loss (400-7128 mL) was observed, with no significant differences between groups. There were no changes in plasma electrolyte levels or osmolality. Transfusion requirements were similar in both groups. CONCLUSION: Desmopressin did not reduce intraoperative blood loss or transfusion requirements during hepatectomy despite raising clotting factor levels and improving tests of hemostasis.
Authors: P A Carless; D A Henry; A J Moxey; D O'Connell; B McClelland; K M Henderson; K Sly; A Laupacis; D Fergusson Journal: Cochrane Database Syst Rev Date: 2004