desmopressin improves hypothermia-induced impairment of primary haemostasis in healthy volunteers

Cardiothoracic and Vascular Anesthesia


Low-dose desmopressin improves hypothermia-induced impairment of primary haemostasis in healthy volunteers


Ng KFJ, Cheung CW, Lee Y, et al (The Univ of Hong Kong, China) Anaesthesia 66:999-1005, 2011§



G.P. Gravlee, MD



Evidence Ranking


• A



Expert Rating


• 2



Abstract


Mild hypothermia (34–35 °C) increases peri-operative blood loss. We have previously demonstrated the beneficial effect of in vitro desmopressin on impairment of primary haemostasis associated with hypothermia. This study evaluated subcutaneous desmopressin in 52 healthy volunteers, randomly assigned to receive either normal saline or desmopressin 1.5, 5 or 15 μg (with 13 in each group). Blood samples were collected before and 2 h after drug administration and incubated at 32 and 37 °C. Platelet function analyser PFA-100® closure times were measured. Hypothermia at 32 °C prolonged mean (95% CI) closure times (for adenosine diphosphate/collagen by 11.3% (7.5–15.2%) and for adrenaline/collagen by 16.2% (11.3–21.2%); these changes were reversed by desmopressin. A very small dose was found to be effective (1.5 μg); this dose did not significantly change closure times at 37 °C, but fully prevented its prolongation at 32 °C. Subcutaneous desmopressin prevents the development of hypothermia-induced impairment of primary haemostasis.

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Jan 28, 2017 | Posted by in ANESTHESIA | Comments Off on desmopressin improves hypothermia-induced impairment of primary haemostasis in healthy volunteers

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