Use of desmopressin in the management of aspirin-related and intractable haemorrhage after cardiopulmonary bypass.

Desmopressin (DDAVP) has been used both prophylactically and therapeutically in the management of excessive bleeding after cardiopulmonary bypass. A series of four consecutive cases is presented in which DDAVP was used to treat excessive bleeding, associated with aspirin antiplatelet therapy in three cases and after all other measures had failed in one. The therapeutic use of DDAVP in aspirin-related bleeding after bypass has not been reported previously. There was no measured haemodynamic effect of the regimen used. Bleeding ceased promptly after administration of DDAVP in all cases. No morbidity was observed in any of the patients. The indications for use of DDAVP and postulated mechanisms of action are discussed.