Use of desmopressin to prevent bleeding in surgery

Flordal, Per Anders

doi:10.1080/110241598750004887

Cited by 21 publications

(5 citation statements)

References 77 publications

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“…2,3 Historically, well-documented factors such as prior VTE, malignancy, trauma, pregnancy, obesity, age $65 years, tobacco use, and thrombophilic disorders have been shown to contribute to the risk of postoperative VTE by inducing a proinflammatory state. [4][5][6] Administration of general anesthesia and intraoperative tissue trauma are both known risk factors for postoperative thrombosis. [7][8][9] Recently, red blood cell (RBC) transfusions have been implicated for their role in pathologic thrombus formation postoperatively.…”

mentioning

confidence: 99%

Red Blood Cell Transfusions and Risk of Postoperative Venous Thromboembolism

Sheth

Yakkanti

Ravipati

et al. 2022

J Am Acad Orthop Surg

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Introduction: Postoperative venous thromboembolism (VTE) is a major risk for orthopaedic surgery and associated with notable morbidity and mortality. Knowing a patient's risk for VTE may help guide the choice of perioperative VTE prophylaxis. Recently, red blood cells (RBCs) have been implicated for their role in pathologic thrombosis. Therefore, we examine the association between perioperative RBC transfusion and postoperative VTE after orthopaedic surgery.Methods: A retrospective cohort study was done by conducting a secondary analysis of data obtained from the 2016 American College of Surgeons National Surgical Quality Improvement Program database. Our population consisted of 234,608 adults who underwent orthopaedic surgery. The exposure was whether patients received a perioperative RBC transfusion. The primary outcome was postoperative VTE within 30 days of surgery that warranted therapeutic intervention, which was subsequently split into symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE). Odds ratios (ORs) were estimated using a multivariate logistic regression model.Results: At baseline, 1,952 patients (0.83%) had postoperative VTE (DVT in 1,299 [0.55%], PE in 801 [0.34%], and both DVT and PE in 148 [0.06%]). Seven hundred ninety-five patients (0.3%) received preoperative RBC transfusions only, 11,587 patients (4.9%) received postoperative RBC transfusions only, and 848 patients (0.4%) received both preoperative and postoperative RBC transfusions. Postoperative RBC transfusion was associated with higher odds of VTE (adjusted OR [aOR], 1.47; 95% confidence interval [CI], 1.19-1.81), DVT (aOR, 1.40; 95% CI, 1.09-1.79), PE (aOR, 1.59; 95% CI, 1.14-2.22), and 30-day mortality (aOR, 1.21; 95% CI, 1.01-1.45) independent of various presumed risk factors. When creating subgroups within orthopaedics by Current Procedural Terminology codes, postoperative transfusions in spine (aOR, 2.03; 95% CI, 1.13-3.67) and trauma (aOR,

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confidence: 99%

Red Blood Cell Transfusions and Risk of Postoperative Venous Thromboembolism

Sheth

Yakkanti

Ravipati

et al. 2022

J Am Acad Orthop Surg

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“…In emergency cases, the antihaemostatic effect of ASA can be rapidly reversed with desmopressin, if needed 56 …”

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confidence: 99%

Nordic guidelines for neuraxial blocks in disturbed haemostasis from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine

Breivik

Bang

Jalonen

et al. 2009

Acta Anaesthesiol Scand

155

161

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“…With a prevalence of 3-5% in surgical patients collectively, 1 perioperative impaired platelet function is a topic of high clinical relevance. Such platelet dysfunction is of multifactorial origin.…”

Section: Introductionmentioning

confidence: 99%

“…However, patients treated preoperatively with antiplatelet drugs for prophylaxis against ischaemic events are the predominant group of surgical patients suffering from platelet dysfunction. 1 In this context, aspirin and clopidogrel are the most commonly used drugs. 6 In cases of perioperative bleeding complications in patients with platelet dysfunction, transfusion of platelet concentrates represents a causal therapeutic approach.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid partially improves platelet function in patients treated with dual antiplatelet therapy

Weber

Görlinger

Byhahn

et al. 2011

European Journal of Anaesthesiology

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The results of this study indicate that tranexamic acid potentially corrects defects in arachidonic acid-induced and ADP-induced platelet aggregation imposed by dual antiplatelet therapy. However, platelet aggregation in response to arachidonic acid or ADP in the blood of patients who have not received aspirin and clopidogrel is unaffected by tranexamic acid. These results support the use of tranexamic acid to partially reverse platelet aggregation dysfunction due to antiplatelet therapy.

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Use of desmopressin to prevent bleeding in surgery

Cited by 21 publications

References 77 publications

Red Blood Cell Transfusions and Risk of Postoperative Venous Thromboembolism

Red Blood Cell Transfusions and Risk of Postoperative Venous Thromboembolism

Nordic guidelines for neuraxial blocks in disturbed haemostasis from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine

Tranexamic acid partially improves platelet function in patients treated with dual antiplatelet therapy

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