Desmopressin for prevention of bleeding for thrombocytopenic, critically ill patients undergoing invasive procedures: A randomised, double‐blind, placebo‐controlled feasibility trial

Author:

Desborough Michael J. R.123ORCID,Laing Emma4,Kounali Daphne5,Mora Ana4,Hodge Renate4,Martin Siobhan4,Thomas Helen5,Hudson Cara5,Parsons Joseph5,Shah Akshay67,Hutton Paula6,Parke Tim8,Wise Matthew P.9,Morgan Matthew9,McKechnie Stuart6,Stanworth Simon J.123

Affiliation:

1. Department of Clinical Haematology Oxford University Hospitals NHS Foundation Trust Oxford UK

2. Radcliffe Department of Medicine University of Oxford Oxford UK

3. NHS Blood and Transplant John Radcliffe Hospital Oxford UK

4. NHS Blood and Transplant Clinical Trials Unit Cambridge UK

5. NHS Blood and Transplant Clinical Trials Unit Bristol UK

6. Department of Critical Care Oxford University Hospitals NHS Foundation Trust Oxford UK

7. Nuffield Department of Clinical Neurosciences University of Oxford Oxford UK

8. Department of Critical Care Royal Berkshire Hospital Reading UK

9. Department of Critical Care University Hospital of Wales Cardiff UK

Abstract

AbstractThrombocytopenic patients have an increased risk of bleeding when undergoing invasive procedures. In a multicentre, phase II, blinded, randomised, controlled feasibility trial, critically ill patients with platelet count 100 × 109/L or less were randomised 1:1 to intravenous desmopressin (0.3 µg/kg) or placebo before an invasive procedure. Forty‐three participants (18.8% of those eligible) were recruited, with 41 eligible for analysis. Post‐procedure bleeding occurred in one of 22 (4.5%) in the placebo arm and zero of 19 in the desmopressin arm. Despite liberal inclusion criteria, there were significant feasibility challenges recruiting patients in the critical care setting prior to invasive procedures.

Publisher

Wiley

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