DESMOPRESSIN DOES NOT DECREASE BLEEDING AFTER CARDIAC OPERATION IN YOUNG-CHILDREN

Young children undergoing complex cardiac operation lose more blood af ter cardiopulmonary bypass than do older patients. This study was desi gned to investigate the effect of desmopressin on blood loss during th e first 24 hours after cardiac operation in children undergoing princi pally complex surgical procedures. The study consisted of a randomized , blinded comparison of 112 pediatric patients who received either des mopressin 0.3 mug/kg or saline solution placebo after cardiopulmonary bypass. A coagulation profile including bleeding time, quantitation of von Willebrand factor, and qualitative analysis of the factor VIII:vo n Willebrand factor complex was performed before, 30 minutes after, an d 3 hours after the operation. Blood loss and blood replacement were r ecorded for the first 24 hours after the operation. The surgeon classi fied the technical difficulty of each procedure as simple or complex. Statistical analysis was performed with Student's unpaired t test and chi2 analysis. Si was defined as p < 0.05. Results are listed as mean +/- standard deviation. Data collection was completed for 95 patients. The mean age of all patients was 26 +/- 40 months, and the mean weigh t was 10 +/- 11 kg, with 84 % undergoing complex procedures. There wer e no differences between die desmopressin and placebo groups with resp ect to age, weight, or surgical complexity. Twenty-four-hour blood los s and replacement between the desmopressin and placebo groups were not different (blood loss: desmopressin 30 +/- 33 ml/kg, placebo 35 +/- 3 6; blood replacement desmopressin 65 +/- 43 ml/kg, placebo 64 +/- 46 m l/kg). Coagulation profiles between the desmopressin and placebo group s were not different at any time. We conclude that desmopressin does n ot reduce blood loss or blood replacement in young children after card iopulmonary bypass for either simple or complex cardiac surgical proce dures.