STEPHEN M. PICCA, M.D.
To the editor: Kobrinsky and associates (1) show that patients receiving 1-desamino-8-D-arginine vasopressin (desmopressin) had a decreased blood loss during Harrington rod spinal fusion surgery. The authors speculate that the decreased blood loss was due to various hematologic effects of desmopressin and conclude that "the use of desmopressin in other surgical procedures associated with significant blood loss is recommended."
This conclusion is probably unwarranted. Intraoperatively "a balanced technique with normotension" was used. Unless specifically contraindicated, induced hypotension with a mean blood pressure of about 70 torr is the accepted anesthetic technique (2). This is done to minimize intraoperative blood loss.
PICCA SM. Desmopressin and Blood Loss. Ann Intern Med. ;108:642–643. doi: 10.7326/0003-4819-108-4-642_2
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Published: Ann Intern Med. 1988;108(4):642-643.
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