Effect of Aspirin, Hemodilution and Desmopressin on Platelet Dysfunction
Status:
Completed
Trial end date:
2013-09-01
Target enrollment:
Participant gender:
Summary
Study hypothesis: Desmopressin (DDAVP) can improve platelet function under influence of
aspirin, hemodilution and mild hypothermia
Mild hypothermia (34-35oC) is known to cause platelet dysfunction. This could lead to
increased surgical bleeding and increased transfusion requirement during surgery. Although
this hypothermia-induced platelet dysfunction seems to be reversible with warming, this is
not always possible or desirable.
Desmopressin (DDAVP) is a drug which has proven efficacy in improving platelet function in
uraemic and cirrhosis patients, and in reducing blood loss in selected surgeries. In a recent
study, we have found that subcutaneous injection of 1.5 mcg (1/10th the usual dose) is
already sufficient to fully reverse the platelet dysfunction seen at 32oC. We have
demonstrated in another study that prolongation of the bleeding time in a 20% hemodiluted
sample predicts increased postoperative bleeding after total knee replacement.
We have therefore designed this study as a follow up to our last two studies on DDAVP and
hypothermia, to investigate whether hemodilution affects hypothermia induced platelet
dysfunction and the response to DDAVP. In addition, another common cause of perioperative
platelet dysfunction is the intake of COX inhibitors, particularly aspirin by patients.
Therefor the effect of aspirin on hypothermia induced platelet dysfunction and the response
to DDAVP, will also be investigated.