Jahangirifard Alireza, Razavi Mohammad Reza, Ahmadi Zargham Hosein, Forozeshfard Mohammad
Cardiac Anesthesiology, Tracheal Diseases Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Basic Clin Pharmacol Toxicol. 2017 Sep;121(3):175-180. doi: 10.1111/bcpt.12780. Epub 2017 May 10.
One of the most common risks after a heart transplant is bleeding. In this study, the effect of desmopressin administration on the amount of bleeding and transfusion requirements after heart transplant surgery was investigated. In a double-blind clinical trial, 48 patients who were candidates for heart transplant surgery were randomly assigned to two groups. In the intervention group, patients received desmopressin of 0.3 μg/kg, 30 min. before surgery. Patients in the control group received normal saline at the same amount and time. Homeostasis was evaluated using activated clotting time (ACT), PT, PTT and PLT before, 12 and 24 hr after surgery, and also, chest tube drainage, blood products transfusion requirements during the first day in both groups. No significant differences were found between the groups in terms of ACT, PT, PTT and PLT at all times. Transfusion of packed red blood cells and the mean drainages of chest tube during the first 24 hr after surgery were significantly lower in the desmopressin group compared to the saline group. Desmopressin may reduce post-operative bleeding in patients undergoing heart transplant surgery. Further studies are required to confirm the potential effect of desmopressin on establishing haemostasis after heart transplantation.
心脏移植后最常见的风险之一是出血。在本研究中，调查了去氨加压素给药对心脏移植手术后出血量和输血需求的影响。在一项双盲临床试验中，48名心脏移植手术候选患者被随机分为两组。干预组患者在手术前30分钟接受0.3μg/kg的去氨加压素。对照组患者在相同时间接受相同剂量的生理盐水。在手术前、术后12小时和24小时，使用活化凝血时间（ACT）、凝血酶原时间（PT）、部分凝血活酶时间（PTT）和血小板计数（PLT）评估止血情况，同时评估两组术后第一天的胸腔引流管引流量和血液制品输注需求。两组在所有时间点的ACT、PT、PTT和PLT方面均未发现显著差异。与生理盐水组相比，去氨加压素组术后24小时内的浓缩红细胞输注量和胸腔引流管平均引流量显著更低。去氨加压素可能会减少心脏移植手术患者的术后出血。需要进一步研究以证实去氨加压素对心脏移植后建立止血的潜在作用。
