Hunt BJ.  Desmopressin and bleeding during invasive surgery.  European Journal of Anaesthesiology - Supplement.  14:42-7; discussion 47-9, 1997.(Review)


    Perioperative bleeding is associated with invasive surgery and has traditionally been compensated for by blood transfusion. Concerns about the risk of transfusion-transmitted disease have led to an increasing interest in synthetic hemostatic agents. Desmopressin (1-deamino-8-D-arginine vasopressin), a synthetic analogue of vasopressin, has been shown to be of benefit in the perioperative management of von Willebrand's disease or mild hemophilia A. This paper addresses the role of desmopressin and bleeding during invasive surgery, particularly during cardiopulmonary bypass.  Clinical trials using desmopressin in open cardiac surgery indicate that it may reduce blood loss in those with an excessive bleeding tendency. However, it is difficult to identify this group pre-operatively.