Dados do Trabalho

Título

Analysis of Blood Coagulation with Prophylactic Administration of Desmopressin in Valvular Heart Surgeries: A Randomized Controlled Trial

Objetivo

This study assesses blood coagulation, both clinically and through laboratory analyses, following prophylactic desmopressin administration in heart valve surgeries.

Métodos

A prospective, randomized clinical study was conducted at the Heart Institute of the Hospital das Clínicas. A total of 108 adult patients undergoing heart valve surgeries were enrolled between February 2015 and November 2016. Patients were randomly assigned to receive prophylactic desmopressin or placebo upon admission. Post-heparin reversal, desmopressin was administered to the intervention group, while the control group received a placebo. Blood samples were collected at three different time points for coagulation and perioperative bleeding analysis through laboratory tests, surgical drain flow, and blood component consumption within 48 hours.

Resultados

Of the 108 patients, 54 were in the intervention group and 54 in the control group. Significant differences in Factor VIII levels at 2 hours were observed between the two groups. Coagulation tests, viscoelastic analysis, and platelet aggregation remained consistent across both groups. Surgical drain flow, blood balance, and blood component consumption did not significantly differ. Mechanical ventilation time showed a notable difference, but there were no disparities in complications, hospital and ICU stays, or 30-day mortality.

Conclusão

Prophylactic desmopressin use in heart valve surgeries did not demonstrate efficacy in achieving a hemostatic effect compared to the control group.