There were no overall differences reported in the risk of all‐cause mortality or thrombotic events (myocardial infarction, stroke and venous thromboembolism) for patients treated with desmopressin. Desmopressin Acetate Nasal Spray is not an indicated formulation for the treatment of primary nocturnal enuresis due to a higher risk of hyponatremia and hyponatremic convulsions with the use of the nasal spray formulation compared to desmopressin tablets seen in Participants were taking antiplatelet agents (cyclo‐oxygenase‐1 inhibitors, phosphodiesterase inhibitors or P2YThe primary outcome was the total volume of allogeneic red cells transfusedWe searched for RCTs in the Cochrane Central Register of Controlled Trials (Two independent review authors initially used an online systematic review management tool (DistillerSR; The full texts of all potentially relevant trials were then formally assessed for eligibility against the criteria outlined above by two independent review authors. *Downgraded one point because of risk of bias from blinding of outcome assessors and incomplete outcome data. In six trials we considered blinding of outcome assessors to be at low risk of bias because the person preparing the desmopressin or matching placebo was not otherwise involved in the trial A key problem for several trials was whether to include individuals with exsanguinating or large‐volume hemorrhages after randomization. It acts by increasing plasma von Willebrand factor, factor VIII and intracellular platelet calcium/sodium ion concentrations, and by increasing formation of procoagulant platelets and platelet adhesion to collagen under flow The aim of this review was to examine the evidence for perioperative administration of desmopressin to reduce bleeding risk and transfusion requirements for people with platelet dysfunction as a result of antiplatelet drug therapy or CPB.This systematic review followed the methods in the prospectively registered update of a Cochrane review We only included randomized controlled trials (RCTs) of participants undergoing any type of elective or emergency surgery. Patients treated with desmopressin were transfused with fewer red cells (MD, −0.65 units; 95% Confidence Interval [CI], −1.16 to −0.13 units), lost less blood (MD, −253.93 mL; 95% CI, −408.01 to −99.85 mL) and had a lower risk of re‐operation due to bleeding (pOR, 0.39; 95% CI, 0.18–0.84). Concerta is a brand-name prescription drug that’s used to treat attention deficit hyperactivity disorder (ADHD). *Downgraded one point because of risk of bias from blinding of outcome assessors and incomplete outcome data.
All authors critically revised the manuscript.M. *Downgraded one point because of risk of bias from blinding of outcome assessors and incomplete outcome data. NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKCorrespondence: Michael J. R. Desborough, NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UK.NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKDepartment of Colorectal Surgery, Oxford University Hospitals NHS Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKCorrespondence: Michael J. R. Desborough, NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UK.NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKDepartment of Colorectal Surgery, Oxford University Hospitals NHS Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKNHS Blood and Transplant, John Radcliffe Hospital, Oxford, UKOxford Clinical Research in Transfusion Medicine, Nuffield Division of Clinical Laboratory Sciences, University of Oxford, Oxford, UKUse the link below to share a full-text version of this article with your friends and colleagues.
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