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Heparin, DDAVP and the bleeding time
1Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
The effect on the bleeding time of heparin, followed by an infusion with desmopressin (DDAVP) 0.3 micrograms/kg or placebo in a randomized, double-blind set-up, was investigated in 20 patients treated for acute venous thromboembolism. The bleeding time was on the average prolonged by 90% (95% confidence interval 46%-134%) after at least 1 day of treatment with heparin. At that point DDAVP shortened the bleeding time by 23% with a confidence interval of -35% to -11% whereas the effect of placebo was -2% with a confidence interval of -23% to +20%. There was also a shortening of the APTT after DDAVP but not after placebo. It is concluded that DDAVP induces a partial reversal of the effect of heparin on the bleeding time, and that DDAVP should be tried in case of hemorrhagic problems.
The effect on the bleeding time of heparin, followed by an infusion with desmopressin (DDAVP) 0.3 micrograms/kg or placebo in a randomized, double-blind set-up, was investigated in 20 patients treated for acute venous thromboembolism. The bleeding time was on the average prolonged by 90% (95% confidence interval 46%-134%) after at least 1 day of treatment with heparin. At that point DDAVP shortened the bleeding time by 23% with a confidence interval of -35% to -11% whereas the effect of placebo was -2% with a confidence interval of -23% to +20%. There was also a shortening of the APTT after DDAVP but not after placebo. It is concluded that DDAVP induces a partial reversal of the effect of heparin on the bleeding time, and that DDAVP should be tried in case of hemorrhagic problems.