Desmopressin and surgical hemostasis

Correction of the hemorrhagic tendency and improved surgical hemostasis in mild hemophilia and von Willebrand's disease are acknowledged actions of desmopressin acetate (1-desamino-8-D-arginine vasopressin), but its effect in acquired disorders of platelet function and in patients with presumably normal hemostatic processes is disputed. Two comparative trials in adults undergoing cardiac surgery^1,2 and one in patients undergoing spinal fusion³ demonstrated that desmopressin reduced operative and postoperative blood loss, and a fourth⁴ reported a decrease in bleeding during cardiac operations, although not in the postoperative period. On the other hand, the trial by Hackmann et al. (Nov. 23 issue), …