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Prophylactic treatment with desmopressin does not reduce postoperative bleeding after coronary surgery in patients

Hilde Pleym1, Roar Stenseth, Alexander Wahba

  • 1Departments of Anesthesiology, St Olav University Hospital, Trondheim, Norway. hilde.pleym@stolav.no

Anesthesia and Analgesia
|February 26, 2004
PubMed

Insights

Desmopressin did not reduce postoperative bleeding in patients undergoing coronary artery bypass grafting (CABG) who continued aspirin therapy until the day before surgery. Aspirin continuation may increase bleeding risk in these cardiac surgery patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Surgical Hemostasis

Background:

  • Desmopressin, a vasopressin analog, possesses hemostatic properties.
  • Aspirin ingestion shortly before cardiac surgery can impair platelet function and potentially increase bleeding.
  • The impact of desmopressin on bleeding in aspirin-treated coronary artery bypass grafting (CABG) patients is unclear.

Purpose of the Study:

  • To evaluate the efficacy of desmopressin in reducing postoperative bleeding.
  • To assess desmopressin's effect in CABG patients who took aspirin until the day before surgery.

Main Methods:

  • Prospective, randomized, double-blinded, placebo-controlled trial.
  • 100 CABG patients were randomized to receive desmopressin (0.3 µg/kg) or placebo after heparin neutralization.
  • Postoperative blood loss was measured over 16 hours.

Main Results:

  • Mean blood loss was 606 mL (desmopressin group) vs. 601 mL (placebo group).
  • No statistically significant difference in blood loss was observed (P = 0.93).
  • The 95% confidence interval for the difference was -107 to 117 mL.

Conclusions:

  • Desmopressin does not effectively reduce postoperative bleeding in CABG patients treated with aspirin until the day prior to surgery.
  • Continuing aspirin therapy until the day before CABG may be associated with increased postoperative bleeding.
  • Further research may be needed to optimize bleeding management in this patient population.
Abstract

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