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

Abstract

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.