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Desmopressin does not decrease blood loss and transfusion requirements in patients undergoing hepatectomy

[La desmopressine ne réduit pas les pertes sanguines et les besoins de transfusion pendant l’hépatectomie]

Andrew Y.C. Wong, MB CHB FHKCA FHKAM^*, Michael G. Irwin, MB CHB DA FRCA FHKCA FHKAM^*, Theresa W.C. Hui, MBBS FANZCA FHKCA FHKAM^*, Serena K.Y. Fung, MBBS FANZCA FHKCA FHKAM, S.T. Fan, MS MD FRCS FHKCS FHKAM and Edmond S.K. Ma, MBBS MRCP MRCPATH FHKAM

^* From the Departments of Anaesthesiology,
Surgery, and
Pathology, Queen Mary Hospital, University of Hong Kong; and
the Department of Anaesthesia, United Christian Hospital, Kwun Tong, Hong Kong, China.

Address correspondence to: Dr. A.Y.C. Wong, Honorary Assistant Professor, Department of Anaesthesiology, F2, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. Fax: 852-28553384; E-mail: ayc_wong{at}hotmail.com

Purpose: To determine the effects of desmopressin on coagulation and blood loss in patients undergoing elective partial hepatectomy.

Methods: A randomized, controlled and double-blind study on 59 patients who received either 0.3 µg•kg^-1 of desmopressin or an equal volume of normal saline (control) infused intravenously over 20 min after induction of general anesthesia.

Results: There was an increase in plasma levels of factors VIII and von Willebrand after the infusion of study drug in both groups (P < 0.001). The activated partial thromboplastin time was shortened in Group D whereas prothrombin time was prolonged in Group C; (P = 0.02). A large range of intraoperative blood loss (400–7128 mL) was observed, with no significant differences between groups. There were no changes in plasma electrolyte levels or osmolality. Transfusion requirements were similar in both groups.

Conclusion: Desmopressin did not reduce intraoperative blood loss or transfusion requirements during hepatectomy despite raising clotting factor levels and improving tests of hemostasis.

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