Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul 26;6(5):e39226.
doi: 10.5812/aapm.39226. eCollection 2016 Oct.

The Effect of Desmopressin on the Amount of Bleeding in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Cardiopulmonary Bypass Pump After Taking Anti-Platelet Medicine

Ali Mirmansoori  1 , Farnoush Farzi  1 , Abbas Sedighinejad  1 , Vali Imantalab  1 , Ali Mohammadzadeh  1 , Zahra Atrkar Roushan  2 , Samaneh Ghazanfar Tehran  1 , Maryam Nemati  1 , Afsaneh Dehghan  1
Affiliations

The Effect of Desmopressin on the Amount of Bleeding in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Cardiopulmonary Bypass Pump After Taking Anti-Platelet Medicine

Ali Mirmansoori et al. Anesth Pain Med. .

Abstract

Background: Coronary artery bypass grafting (CABG) is a common surgical intervention at the end-stages of coronary artery occlusion disease. Despite the effectiveness of CABG, it may have particular complications, such as bleeding during and after surgery. So far, there have been many drugs used to reduce bleeding.

Objectives: This study aimed at investigating the effects of desmopressin on the amount of bleeding in patients undergoing CABG with a cardiopulmonary bypass pump (CPBP) who were taking anti-platelet medicine.

Methods: One hundred patients scheduled for elective CABG with a CPBP were included in a prospective, placebo-controlled, double-blinded clinical trial study. They were randomly divided into two groups. One group received desmopressin (40 μg) and the other group received a placebo (isotonic saline). Seven patients were excluded from the study, and 47 and 46 patients participated in the desmopressin and control groups, respectively. The methods of monitoring and the anesthetic techniques were similar in both groups, and all surgeries were performed by one surgeon. Variables including age, gender, pump time, aortic clamp time, duration of surgery, complications (e.g., nausea and vomiting, blood pressure changes), the necessity to receive blood products, and coagulation tests (prothrombin time, partial thromboplastin time, international normalized ratio, and bleeding time) were assessed. Data were statistically analyzed with SPSS software version 17.

Results: There was no significant difference between the groups regarding age, gender, pump time, clamp time, duration of surgery, complications, and the changes in hemoglobin and coagulation test measurements (P > 0.05). No significant difference was noted between the groups regarding the rate of bleeding after surgery (359.3 ± 266.2 in group D vs. 406.3 ± 341.6 in group P (control group); P = 0.208). However, the platelet changes after surgery in both groups were significantly different. The analysis revealed that the rate of thrombocytopenia after surgery was higher in the control group (P = 0.012).

Conclusions: Our study showed that desmopressin could not reduce the amount of blood loss after CABG. Also, desmopressin did not have a significant effect on coagulation status. Therefore, based on the results of our study, it seems that the use of this medication cannot be a helpful for patients with any indication for CABG.

Keywords: Bleeding; Coronary Artery Bypass graft; Desmopressin.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Enrollment and Outcomes
See this image and copyright information in PMC

References

    1. AtaiJafari A, Najafi M, Hosseini S, Hoshyarrad A, Heshmat R. Diet quality in patients undergoing coronary artery bypass surgery based on quality indicators the Mediterranean diet. Iran J Diabetes Lipid Disord. 2008;7(4):407–18.
    1. Tabari M, Soltani G, Zirak N, Goshayeshi L. Effect of magnesium sulfate on cardiac arrhythmias after open heart surgery. Sci J Kurdistan Univ Med Sci. 2009;14(1):47–54.
    1. Despotis GJ, Santoro SA, Spitznagel E, Kater KM, Cox JL, Barnes P, et al. Prospective evaluation and clinical utility of on-site monitoring of coagulation in patients undergoing cardiac operation. J Thorac Cardiovasc Surg. 1994;107(1):271–9. - PubMed
    1. Harker LA. Bleeding after cardiopulmonary bypass. N Engl J Med. 1986;314(22):1446–8. doi: 10.1056/NEJM198605293142209. - DOI - PubMed
    1. Khuri SF, Wolfe JA, Josa M, Axford TC, Szymanski I, Assousa S, et al. Hematologic changes during and after cardiopulmonary bypass and their relationship to the bleeding time and nonsurgical blood loss. J Thorac Cardiovasc Surg. 1992;104(1):94–107. - PubMed

LinkOut - more resources