Abstract 1853: Desmopressin Acetate Reduces Blood Loss After Cardiac Surgery: A Double-bind Randomized Controlled Trial
It has been suggested that desmopressin acetate (DDAVP) administration reduces blood loss after cardiac surgery. It acts by releasing von Willebrand factor multimers from endothelial cells, leading to an increase in plasma levels of von Willebrand factor and an enhancement of primary hemostasis. We have investigated the effect of DDAVP administration in a double-blind, randomized, prospective trial including 150 patients placed on cardiopulmonary bypass. Seventy-five patients received 0.3 micrograms/kg DDAVP and 75 patients received a placebo administered in a 50 ml saline solution over 15 min immediately after end of surgery. Results showed significant differences in total blood loss per square meter (258 +/− 106 ml in the DDAVP group vs 526 +/− 314 ml in the placebo group, p<0.001), and in necessity for red cell transfusions (1142 +/− 205 ml in the DDAVP group vs 1774 +/− 385 ml in the placebo group, p<0.005) in the first 72 hr after surgery. The prolongation of bleeding time and the decrease of factor VIII:C and factor VIII:von Willebrand factor 90 min after treatment were significantly lower (p less than .001) in the DDAVP group as compared with the placebo group. The rate of thrombosis and cardiac necrosis did not differ significantly between groups (p>0.05). In conclusion, the administration of DDAVP in patients placed on cardiopulmonary bypass reduces total blood loss and needing of transfusion, without resulting in higher rates of complications.