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June 1989

Surgery in Patients With Coagulopathies Using Desmopressin Acetate

Author Affiliations

Chapel Hill, NC

Arch Otolaryngol Head Neck Surg. 1989;115(6):663. doi:10.1001/archotol.1989.01860300017006

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At the 92nd annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Dr Egbert DeVries, MD, and coworkers, Pittsburgh, Pa, described their experience over the last 2 years in performing surgery in patients with significant coagulopathies that had been corrected preoperatively by employing 1-D-amino (8-D-arginine)-vasopressin (desmopressin acetate [DDAVP, USV Laboratories, Tarrytown, NY]). This drug has been shown to normalize factor VIII coagulant, factor VIII–related antigen, and von Willebrand factor (ristocetin cofactor), thus correcting prolonged bleeding times. Prior to the widespread availability of desmopressin acetate, these patients would have been administered blood products with the inherent risks of transfusion reaction or possible transmission of blood-born disease, especially hepatitis and the acquired immunodeficiency syndrome.

Dr DeVries related a particularly interesting case. He and his colleagues were asked to examine a 76-year-old woman with renal failure complicated by acute respiratory failure. Coagulation studies in this patient showed abnormal

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