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DOI: 10.1055/s-0038-1646480
Effects on Coagulation and Fibrinolysis of Desmopressin in Patients Undergoing Total Hip Replacement
Publikationsverlauf
Received 11. April 1991
Accepted 17. Juni 1991
Publikationsdatum:
26. Juli 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/199106/lookinside/thumbnails/10-1055-s-0038-1646480-1.jpg)
Summary
Twelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.
Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.
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