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Easy bruisability, aspirin intolerance, and response to DDAVP
1Department of Surgery, Brown University School of Medicine, Providence, RI.
The Laryngoscope
|February 1, 1993
Summary
Easy bruisability in patients can increase surgical bleeding risk. Desmopressin acetate (DDAVP) effectively normalized bleeding times prolonged by aspirin challenge, confirming its utility in managing bleeding disorders.
Area of Science:
- Otolaryngology
- Hematology
- Pharmacology
Background:
- Easy bruisability is a common concern for patients undergoing otolaryngological surgery.
- Pre-operative screening may not identify all patients at risk for bleeding disorders.
- Aspirin's antiplatelet effects can exacerbate bleeding tendencies.
Purpose of the Study:
- To evaluate the diagnostic utility of aspirin challenge in patients with easy bruisability.
- To assess the efficacy of desmopressin acetate (DDAVP) in correcting aspirin-induced bleeding.
- To confirm aspirin sensitivity and document hemostatic improvement.
Main Methods:
- Ten female patients with easy bruisability underwent an aspirin challenge test.
- Ivy bleeding times (BT) were measured at baseline, after aspirin challenge, and after DDAVP therapy.
- Patients received daily aspirin for 7 days followed by DDAVP administration.
Main Results:
- Baseline bleeding times were normal in 6 patients and prolonged in 4.
- Aspirin significantly prolonged bleeding times in all patient groups, including controls.
- Desmopressin acetate (DDAVP) normalized prolonged bleeding times in all evaluated groups.
Conclusions:
- Aspirin challenge is a valuable tool for identifying aspirin sensitivity in patients with easy bruisability.
- DDAVP effectively corrects bleeding times prolonged by aspirin, improving hemostasis.
- This diagnostic and therapeutic approach aids in managing bleeding risks in susceptible patients.