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Jahangirifard A, Mirtajani SB, Madadi F. Effect of Desmopressin on Bleeding After Heart Surgeries: A Narrative Review. Anesth Pain Med 2023; 13:e133894. [PMID: 37645010 PMCID: PMC10461384 DOI: 10.5812/aapm-133894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/01/2023] [Accepted: 02/12/2023] [Indexed: 08/31/2023] Open
Abstract
Desmopressin is an analog of the antidiuretic hormone (vasopressin), which causes anticoagulant activity by increasing plasma factor 8. The use of desmopressin dates back to 1977, when this hormone was used to prevent bleeding during tooth extraction and surgery in patients with hemophilia A and von Willebrand disease. After that, this hormone was expanded to prevent bleeding in congenital defects and conditions such as chronic kidney and liver failure. Also, this hormone is used to prevent bleeding in major surgeries such as heart surgery, where the patient loses much blood and needs a blood transfusion. Considering the importance of desmopressin in bleeding control, the present study was conducted to investigate the possible effect of this hormone in heart surgery.
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Affiliation(s)
- Alireza Jahangirifard
- Lung Transplant Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Bashir Mirtajani
- Lung Transplant Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firoozeh Madadi
- Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Youssefy A, Ghabasiah A, Heidari F, Alvandi S, Bastaninezhad S, Hosseini J, Tajdini A. The Effect of Desmopressin Intraoperatively on Hemorrhage During the Rhinoplasty Surgery. Indian J Otolaryngol Head Neck Surg 2022; 74:4761-4765. [PMID: 36742884 PMCID: PMC9895179 DOI: 10.1007/s12070-021-03046-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/26/2021] [Indexed: 02/07/2023] Open
Abstract
This clinical trial discusses the efficacy of premedication with desmopressin in the management of bleeding and clears the surgical field during rhinoplasty surgery. This study is a randomized, double-blinded placebo-control clinical trial. Seventy patients were enrolled in this study and divided into two equal intervention-control groups. Thirty minutes before surgery, the intervention group received 500 ml of normal saline containing 0.1 μg/kg desmopressin and, the control group received 500 ml of normal saline. According to the surgeon's opinion, the local distribution of bleeding was dramatically different in both groups. While DDAVP receivers had grade 1 or 2 bleeding (according to the FROMME-BOEZAART grading score), the control group had grade 3 or 4 bleeding, and this difference was statistically meaningful. It seems that intravenous DDAVP can reduce bleeding and clear the surgical field during rhinoplasty surgery, but further studies are needed to determine the exact role and dose of the DDAVP.
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Affiliation(s)
- Abolqasem Youssefy
- Anesthesiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - AmirHossein Ghabasiah
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Farrokh Heidari
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Sepideh Alvandi
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Shahin Bastaninezhad
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Jawad Hosseini
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
| | - Ardavan Tajdini
- Otorhinolaryngology Research Center, Amiralam Hospital, Tehran University of Medical Sciences, North Sa’adi Ave, Enghelab Blv, Tehran, Iran
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