Summary
The response of components of the coagulation and fibrinolysis systems to infusion of DDAVP has been examined in patients undergoing elective surgery. In the DDAVP treated group there was a significant increase, compared to control, in plasminogen activator (by fibrin plates p <0.005, ECLT p <0.0125, by Student’s t test) before operation. No difference between groups was seen by either methods in the activator levels in samples 24 h postoperation, whereas a significant drop (p <0.002) in protein C concentration was observed at this stage in the treated group. Levels of factor VIII components were significantly higher (p <0.005) than control at all stages of operation and a significant shortening (5 sec p <0.05) of the APTT was seen at all stages (apart from 24 h samples). DDAVP infusion therefore may exacerbate the hypercoagulable state observed in surgical patients without preventing the (post-operatively) fibrinolytic shutdown. Instead, infusion tends to produce fibrinolytic depletion at the key mid-operative stage.
Key words
Plasminogen activator - Factor VIII components - Protein C - Haemostasis - DDAVP
