Use of desmopressin to prevent bleeding complications in patients treated with aspirin

Abstract

Aspirin induces a haemorrhagic diathesis that persists for at least 1 week after discontinuation of the drug. The effect of the vasopressin analogue desmopressin was studied in 12 patients treated with aspirin who were undergoing cholecystectomy. Desmopressin was given to six of these patients. There were five postoperative bleeding complications; all occurred in patients who had not received desmopressin (P < 0.05). The bleeding time was prolonged in aspirin-treated patients and normalized by desmopressin (P < 0.05). Desmopressin can be used safely to prevent bleeding induced by aspirin.

Fibrinolytic Inhibition With Tranexamic Acid Reduces Blood Loss and Blood Transfusion After Knee Arthroplasty

“…Aspirin has been shown to increase bleeding complications after cholecystectomy (Flordal and Sahlin 1993) and blood loss in cardiovascular surgery (Levy 1994). We asked our patients to avoid any intake of NSAIDs for at least one week before operation.…”

The role of anticoagulants, antiplatelet agents, and their reversal strategies in the management of intracerebral hemorrhage

“…74 Desmopressin has been known to increase platelet reactivity in patients treated with aspirin by releasing a greater number of von Willibrand multimers. 24 The role of intravenous desmopressin in decreasing bleeding during cardiac surgery is controversial, whereas rVIIa has shown promise preclinically as a possible agent. 2,30,53 Some authors have described variations of platelet reversal regimens as standard at their centers.…”

Emergency Reversal of Antiplatelet Agents in Patients Presenting with an Intracranial Hemorrhage: A Clinical Review

“…Furthermore, other agents for reversal of the aspirin effect have received basic investigation. Desmopressin seems capable of correcting aspirin-induced platelet dysfunction, although large clinical studies describing relevant outcome parameters have not been undertaken [46][47][48]. Altman, et al [49] treated healthy volunteers with aspirin and found that recombinant factor VIIa (rFVIIIa) combined with other agonists was able to reverse the anti-aggregating effect of aspirin.…”