RESPONSE TO DESMOPRESSIN (DDAVP): PREOPERATIVE TESTING
Abstract
BACKGROUND The principle of treatment or prevention of bleeding in von Willebrand disease (vWd)is correction of dual plasma deficiency of von Willebrand factor (vWF) and factor VIII(F VIII). This can be achieved by desmopressin (DDAVP) or plasma fractions. DDAVPeffect was tested in von Willebrand patients before surgical procedure. METHODS DDAVP test was done in 13 vWd patients (type 1) by slow infusion of DDAVP (0.3 ug/bwMinirin, Ferring) in 100 ml of saline. Before, after 1, 4 hours venous blood sample wastaken for F VIII:C, vWF:Rco, vWF:CBA, vWF:Ag. RESULTS After 1 hour, preinfusion levels comparison showed, F VIII:C, vWF:CBA, vWF:Ag were 2–4times higher, vWF:RCo 2–3 times higher. 4 hours later all the levels were one third to onefourth lower but still high enough to prevent bleeding. CONCLUSIONS DDAVP raises vWF in vWd patients (except type 3) and has efficacious hemostaticresponse as it prevents or stop bleeding. Using DDAVP test, 2–4 times higher levels of F VIIIand vWF were noticed 1 hour after DDAVP infusion. The data can help us to decide theoptimal treatment to prevent and stop bleeding in vWd patientsDownloads
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