Desmopressin for minimising perioperative allogeneic blood transfusion.

摘要: Background Public concerns regarding the safety of blood have prompted reconsideration use allogeneic (blood from an unrelated donor) transfusion and a range techniques designed to minimise requirements. Objectives To examine efficacy desmopressin acetate (1-deamino-8-D-arginine-vasopressin) in reducing peri-operative loss need for red cell (RBC) patients who do not congenital bleeding disorders. Search methods We identified studies by searching CENTRAL (The Cochrane Library 2008, Issue 1), MEDLINE (1950 2008), EMBASE (1980 Internet (to May bibliographies published articles. Selection criteria Controlled parallel-group trials which adult scheduled non-urgent surgery were randomised (DDAVP) or control group that did receive DDAVP treatment. Trials eligible inclusion if they reported data on number exposed volume transfused. Data collection analysis Primary outcomes were: transfusion, amount transfused. Other measured loss, re-operation bleeding, post-operative complications (thrombosis, myocardial infarction, stroke), mortality, length hospital stay. Treatment effects pooled using random-effects model. Main results Nineteen included total 1387 RBC transfusion. significantly reduce risk exposure (relative (RR) 0.96, 95% confidence interval (CI) 0.87 1.06). However, reduced (weighted mean difference (WMD) -241.78 ml, CI -387.55 -96.01 ml). Although appeared overall transfused during period result would be considered clinically significant (WMD -0.3 units, -0.60 -0.01 units). Risk due was (RR 0.69, 0.26 1.83). treatment associated with increased death infarction 1.72, 0.68 4.33; RR 1.38, 0.77 2.50, respectively). Authors' conclusions There is no convincing evidence minimises disorders. suggest there some benefit as means observed reductions small generally important. Based currently available evidence, cannot supported.