Effects of desmopressin on platelet function under conditions of hypothermia and acidosis: an in vitro study using multiple electrode aggregometry

• Published in: Anaesthesia Vol. 65; no. 7; pp. 688 - 691
• Main Authors: Hanke, A. A., Dellweg, C., Kienbaum, P., Weber, C. F., Görlinger, K., Rahe‐Meyer, N.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2010; Wiley-Blackwell
• Subjects: Acidosis - blood; Adenosine Diphosphate - pharmacology; Adult; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Platelets - drug effects; Blood Platelets - physiology; Cells, Cultured; Deamino Arginine Vasopressin - pharmacology; Electrodes; Female; Hemostatics - pharmacology; Humans; Hydrogen-Ion Concentration; Hypothermia; Hypothermia - blood; Male; Medical sciences; Platelet Activation - drug effects; Platelet Aggregation - drug effects; Young Adult; Desmopressin; Metabolic disorder; Platelet; Peptides; Antidiuretic; Neurohypophyseal hormone; Anesthesia; Acid base balance disorder; Acidosis; Hypothermia
• ISSN: 0003-2409; 1365-2044; 1365-2044
• DOI: 10.1111/j.1365-2044.2010.06367.x

Summary Hypothermia and acidosis lead to an impairment of coagulation. It has been demonstrated that desmopressin improves platelet function under hypothermia. We tested platelet function ex vivo during hypothermia and acidosis. Blood samples were taken from 12 healthy subjects and assigned as follows: normal pH, pH 7.2, and pH 7.0, each with and without incubation with desmopressin. Platelet aggregation was assessed by multiple electrode aggregometry. Baseline was normal pH and 36 °C. The other samples were incubated for 30 min and measured at 32 °C. Acidosis significantly impaired aggregation. Desmopressin significantly increased aggregability during hypothermia and acidosis regardless of pH, but did not return it to normal values at low pH. During acidosis and hypothermia, acidosis should be corrected first; desmopressin can then be administered to improve platelet function as a bridge until normothermia can be achieved.