The effects of desmopressin and 6% hydroxyethyl starch on factor VIII:C

被引:52
作者
Conroy, JM
Fishman, RL
Reeves, ST
Pinosky, ML
Lazarchick, J
机构
[1] MED UNIV S CAROLINA,DEPT ANESTHESIA & PERIOPERAT MED,CHARLESTON,SC 29425
[2] MED UNIV S CAROLINA,DEPT PATHOL & LAB MED,CHARLESTON,SC 29425
关键词
D O I
10.1097/00000539-199610000-00026
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
in moderate doses of 20 mL/kg (1.2 g/kg), hydroxyethyl starch (HES) 6% decreases factor VIII:C activity. Desmopressin (DDAVP) increases circulating levels of factor VIII:C by stimulating the release of factor VIII:C from peripheral storage sites. The objective of this study was to monitor the changes in factor VIII:C associated with sequential HES and DDAVP administration. Thirty patients undergoing surgical procedures with a predicted blood loss of less than 750 mL were enrolled. After induction of anesthesia, HES was administered, 20 mL/kg, to a maximum of 1500 mL, at a rate to meet intraoperative fluid requirements. Patients then randomly received either a 10-mL solution containing 0.3 mu g/kg of DDAVP (Group 1) or 10 mL of normal saline (Group 2). After HES administration, factor VIII:C levels decreased significantly, to 69% of baseline, in both groups. After study drug administration, factor VIII:C in Group 1 increased significantly to 135% of baseline at 30 min and 115% of baseline at 60 min while in Group 2 average factor VIII:C levels remained below baseline at 30 and 60 min. DDAVP produced an increase in factor VIII:C activity despite HES administration and should be considered a treatment option for the mild coagulopathy infrequently associated with HES administration.
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收藏
页码:804 / 807
页数:4
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