ABSTRACT
The blood loss-reducing effect of desmopressin during dextran therapy was studied in a double-blind fashion in 79 elderly but otherwise healthy patients with preoperative normal bleeding time undergoing total hip replacement for primary coxarthrosis. An infusion of desmopressin (0.3 microgram/kg body weight) or placebo was randomly administered immediately after administration of spinal anaesthesia and six hours later. Haemostasis was evaluated on the basis of vWF: ristocetin cofactor activity, FVIII: C activity, human tissue plasminogen activator (tPA) plasminogen activator inhibitor type (PAI), beta-thromboglobuline (beta TG) and a clot impedance test (Sonoclot). There were no statistically significant differences (P > 0.05) in mean blood loss or transfusion requirements between the placebo and the desmopressin group. There was a significantly increase (P < 0.01) both in vWF: ristocetin cofactor and in FVIII: C activity after both infusions of desmopressin compared with placebo. There was no significant difference in beta TG, tPA, PAI or Sonoclot analysis between the groups. In conclusion, desmopressin did not reduce blood loss in patients undergoing total hip replacement.
Subject(s)
Blood Loss, Surgical/prevention & control , Deamino Arginine Vasopressin/therapeutic use , Dextrans/therapeutic use , Hemostatics/therapeutic use , Hip Prosthesis , Aged , Deamino Arginine Vasopressin/adverse effects , Double-Blind Method , Female , Humans , Male , Middle Aged , Prospective Studies , Thromboembolism/prevention & controlABSTRACT
The transmission of light through 22 platelet packs was monitored during storage with a specially designed apparatus in order to estimate the quality of the platelet concentrates without risking contamination. The changes in light transmission during a 7 day storage period were compared with other properties of platelets upon day 1 and day 7, namely aggregometry responses (to collagen, ADP, and calcium ionophore A23187), platelet factor 4 release, lactate dehydrogenase extracellular activity and pH. On day 7 additional aggregometry tests were carried out with pairs of activators (collagen + ADP, collagen + A23187, collagen + epinephrine, and collagen + arachidonic acid). The 8 concentrates judged as being inferior in quality by the optical apparatus also, with 1 exception, showed inferior quality as assessed from aggregometry responses and/or biochemical analyses.
