How do you treat bleeding disorders with desmopressin?

Özgönenel, Bülent; Rajpurkar, Madhvi; Lusher, Jeanne M.

doi:10.1136/pgmj.2006.052118

Cited by 59 publications

(48 citation statements)

References 23 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the data suggest that VWF levels, although not below 100% before treatment, can also be considered as a limiting factor in the hemostatic process, as the desmopressin-induced elevation in (high molecular weight) VWF promotes platelet functions in thrombus formation and procoagulant activity, and postoperative bleeding stopped in 14 of 16 patients. It is worth noting that disadvantageous effects of desmopressin have been reported, albeit mostly transient and mild, such as mild tachycardia, headache, and facial flushing [54]. A rare, serious side effect in patients with cardiovascular disease is a moderately increased risk of arterial thrombotic effects, i.e.…”

Section: Discussionmentioning

confidence: 99%

Desmopressin treatment improves platelet function under flow in patients with postoperative bleeding

Swieringa

Lancé

Fuchs³

et al. 2015

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Summary. Background: Patients undergoing major cardiothoracic surgery are subjected to dilution, owing to massive fluid infusion and blood component transfusion. These patients may experience bleeding perioperatively, and are frequently treated with the endothelium-activating agent desmopressin. Objectives: To investigate the effect of desmopressin administration on von Willebrand factor (VWF)-dependent coagulant and platelet functions under flow conditions. Patients/methods: Blood from 16 patients with postoperative bleeding was obtained before and after desmopressin treatment (0.3 lg kg À1 body weight), and assessed for coagulant properties and platelet function. Furthermore, VWF antigen levels and multimer composition were determined in both samples. Results: Desmopressin treatment did not change thrombin generation in plasma or whole blood thromboelasticity. Also coagulation factor levels (other than factor VIII) and coagulation times were unchanged, suggesting that desmopressin treatment did not have a major effect on the coagulant activity. On the other hand, desmopressin treatment raised the already high plasma levels of VWF from a median of 116 IU mL À1 (interquartile range [IQR] 102-154 IU mL À1 ) to a median of 160 IU mL À1 (IQR 126-187 IU mL À1 ) (P = 0.007), owing to accumulation of the high molecular weight VWF multimers. Furthermore, desmopressin treatment caused an increase in collagendependent thrombus formation and platelet phosphatidylserine exposure. Markers of thrombus formation correlated with the plasma levels of VWF. In vitro control experiments confirmed a major contribution of VWF to thrombus formation and procoagulant activity under conditions of blood dilution. Conclusions: Desmopressin treatment of patients with bleeding complications after cardiothoracic surgery induces the release of high molecular weight VWF multimers, which enhance platelet activation and thrombus formation under flow conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Desmopressin treatment improves platelet function under flow in patients with postoperative bleeding

Swieringa

Lancé

Fuchs³

et al. 2015

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…A record of all the drugs that the subject took during the week prior to testing should be collected [15]. Treatment with desmopressin, in treating or preventing bleeding episodes in patients with von Willebrand disease, haemophilia A and platelet function defects, should be noted [16]. It is important to know if the patient is pregnant.…”

Section: Methodsmentioning

confidence: 99%

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Magnette¹,

Chatelain²,

Châtelain³

et al. 2016

Thrombosis J

103

View full text Add to dashboard Cite

Ensuring quality has become a daily requirement in laboratories. In haemostasis, even more than in other disciplines of biology, quality is determined by a pre-analytical step that encompasses all procedures, starting with the formulation of the medical question, and includes patient preparation, sample collection, handling, transportation, processing, and storage until time of analysis. This step, based on a variety of manual activities, is the most vulnerable part of the total testing process and is a major component of the reliability and validity of results in haemostasis and constitutes the most important source of erroneous or un-interpretable results.Pre-analytical errors may occur throughout the testing process and arise from unsuitable, inappropriate or wrongly handled procedures. Problems may arise during the collection of blood specimens such as misidentification of the sample, use of inadequate devices or needles, incorrect order of draw, prolonged tourniquet placing, unsuccessful attempts to locate the vein, incorrect use of additive tubes, collection of unsuitable samples for quality or quantity, inappropriate mixing of a sample, etc. Some factors can alter the result of a sample constituent after collection during transportation, preparation and storage.Laboratory errors can often have serious adverse consequences. Lack of standardized procedures for sample collection accounts for most of the errors encountered within the total testing process. They can also have clinical consequences as well as a significant impact on patient care, especially those related to specialized tests as these are often considered as “diagnostic”. Controlling pre-analytical variables is critical since this has a direct influence on the quality of results and on their clinical reliability. The accurate standardization of the pre-analytical phase is of pivotal importance for achieving reliable results of coagulation tests and should reduce the side effects of the influence factors. This review is a summary of the most important recommendations regarding the importance of pre-analytical factors for coagulation testing and should be a tool to increase awareness about the importance of pre-analytical factors for coagulation testing.

show abstract

“…Desmopressin, an analogue of vasopressin, has been successfully used in the prevention and treatment of bleeding associated with uremia, cirrhosis, and medication-induced platelet dysfunction, although there are no clear guidelines for use in these settings 18,19. Ibuprofen is associated with platelet dysfunction 20.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding from Metastatic Prostate Adenocarcinoma to the Stomach

Koop

Brauhmbhatt

Lewis

et al. 2017

ACG Case Reports Journal

View full text Add to dashboard Cite

We present a rare case of gastrointestinal (GI) bleeding associated with metastatic prostate adenocarcinoma to the stomach. Prostate cancer, which is the most common noncutaneous malignancy among men, rarely spreads to the stomach, with only 7 cases reported in the English literature. Symptoms may include abdominal pain, nausea, vomiting, and GI bleeding. Our patient was treated with epinephrine injection and bipolar cautery, but GI bleeding recurred 7 months later when he had worsening of his thrombocytopenia while using ibuprofen.

show abstract

How do you treat bleeding disorders with desmopressin?

Cited by 59 publications

References 23 publications

Desmopressin treatment improves platelet function under flow in patients with postoperative bleeding

Desmopressin treatment improves platelet function under flow in patients with postoperative bleeding

Pre-analytical issues in the haemostasis laboratory: guidance for the clinical laboratories

Gastrointestinal Bleeding from Metastatic Prostate Adenocarcinoma to the Stomach

Contact Info

Product

Resources

About