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. Author manuscript; available in PMC: 2014 Oct 29.
Published in final edited form as: Cochrane Database Syst Rev. 2004;(1):CD001884. doi: 10.1002/14651858.CD001884.pub2
Methods A computer-generated random-number table was used to assign patients to treatment or control groups. Method used to conceal treatment allocation was not described
Participants 115 patients undergoing elective coronary artery bypass graft surgery were randomised after cardiopulmonary bypass (CPB) to one of four groups

  1. Desmopressin (DDAVP) group (MA>50mm): n = 44; M/F = 40/4; mean age (+/−SD) = 61. 5 (9.3) years.

  2. Placebo group (MA>50mm): n = 42; M/F = 36/6; mean age (+/−SD) = 60.9 (9.7) years.

  3. Desmopressin (DDAVP) group (MA<50mm): n = 13; M/F = 9/4; mean age (+/−SD) = 58.8 (10.7) years.

  4. Placebo group (MA<50mm): n = 16; M/F = 11/5; mean age (+/−SD) = 65.8 (10.0) years.


MA = Mean amplitude of the thromboelastogram (TEG)
NB: Patients were divided into groups based upon TEG analysis. Groups 1 and 2 consisted of patients with normal TEG parameters prior to and after separation from CPB (MA>50mm). Groups 3 and 4 consisted ofpatients with normal TEG parameters prior to CPB who demonstrated abnormal TEG values (TEG:MA<50mm) after CPB but prior to DDAVP or placebo administration
Interventions

  1. DDAVP group (MA>50mm) received 0.3 ug/kg of DDAVP IV diluted in 50 ml normal saline after protamine administration and return of the ACT (activated clotting time) to normal, administered over 15 minutes.

  2. Placebo group (MA>50mm) received 50 ml IV normal saline after protamine administration and return of the ACT to normal, administered over 15 minutes.

  3. DDAVP group (MA<50mm) received 0.3 ug/kg of DDAVP IV diluted in 50 ml normal saline after protamine administration and return of the ACT to normal, administered over 15 minutes.

  4. Placebo group (MA<50mm) received 50 ml IV normal saline after protamine administration and return of the ACT to normal, administered over 15 minutes.
Outcomes Number of patients transfused allogeneic blood (n)
Amount of allogeneic blood transfused (units)
Blood loss (ml)
Myocardial infarction (n)
Mortality (n)
Re-operation for bleeding (n)
Notes Quality assessment score (Schulz criteria): 5/7
Transfusion protocol used.
Risk of bias
Item Authors’ judgement Description
Adequate sequence generation? Yes A computer-generated random-number table was used to assign patients to treatment or control groups
Allocation concealment? Unclear B - Unclear
Blinding?
All outcomes		 Yes Double blind.