Hackmann T, Naiman S C
Department of Anaesthesia, University of Alberta Hospitals, Edmonton, Canada.
J Cardiothorac Vasc Anesth. 1991 Jun;5(3):290-3. doi: 10.1016/1053-0770(91)90291-z.
Following two early promising reports that treatment with intravenous DDAVP was helpful in reducing postoperative hemorrhage and the amount of transfusion with homologous blood products in patients who had undergone cardiac surgery with CPB, these results were not repeated in any of the follow-up studies. At the present time, the routine prophylactic use of DDAVP in cardiac surgery cannot be recommended for patients undergoing closure of atrial septal defect, valve repair or replacement, primary CABG, or in children requiring cardiac surgery. The use of DDAVP in complicated procedures or for control of severe postoperative bleeding remains controversial. In the authors' opinion, DDAVP should not be used in cardiac surgery except in patients with a presurgical DDAVP-responsive coagulopathy.
有两份早期的报告显示，静脉注射去氨加压素（DDAVP）有助于减少接受体外循环心脏手术患者的术后出血以及同源血制品的输血量，结果令人鼓舞。然而，在后续的任何研究中均未再现这些结果。目前，对于接受房间隔缺损修补术、瓣膜修复或置换术、初次冠状动脉旁路移植术（CABG）的患者，或需要进行心脏手术的儿童，不建议在心脏手术中常规预防性使用DDAVP。在复杂手术中使用DDAVP或用于控制严重的术后出血仍存在争议。作者认为，除术前存在DDAVP反应性凝血病的患者外，心脏手术中不应使用DDAVP。
