effect of desmopressin in reducing bleeding after cardiac surgery in patients receiving anti-platelet agents

Background: Severe bleeding is an important cause of morbidity and mortality in cardiac surgery using the cardiopulmonary bypass (CPB) pump. Desmopressin, a synthetic analogue of vasopressin, is used to prevent postoperative bleeding in patients with renal insufficiency. The aim of the present study was to evaluate the effect of desmopressin in reducing blood loss after cardiac surgery in patients receiving antiplatelet drugs. Methods: In this prospective clinical trial, 40 patients undergoing coronary artery bypass grafting (CABG) surgery with CPB, aged over 18 years, and on antiplatelet therapy for a week before surgery were divided in two groups. Case and control groups received nasal desmopressin spray and nasal normal saline spray, respectively. Patient vital signs, blood loss, administration of blood products, prescription drugs to improve the coagulation status, serum and whole intake and output of patients, need for a second surgery to control the bleeding, remaining sternum open, mortality due to bleeding, duration of intensive care unit (ICU) stay and mechanical ventilation were recorded. Results: In the case and control groups there were no differences in duration of operation, mechanical ventilation and length of ICU stay. There was no significant difference in terms of postoperative bleeding and intake of blood products between two groups (P>0.05). Reoperation due to bleeding in the case and control groups was observed in 3 (15%), and 1 (5%) patient(s), respectively (P=0.3). Conclusion: Desmopressin has no significant effect on reducing the amount of bleeding after cardiac surgery in patients receiving anti-platelet agents.   Keywords: CABG; cardio pulmonary bypass pump; hemorrhage; desmopressin