Comparison 1. Desmopressin versus control (blood transfused and blood loss).
| Outcome or subgroup title | No. of studies |
No. of participants |
Statistical method | Effect size |
|---|---|---|---|---|
| 1 No. exposed to allogeneic blood - All studies |
19 | 1387 | Risk Ratio (M-H, Random, 95% CI) | 0.96 [0.87, 1.06] |
| 2 No. exposed to allogeneic blood - Type of surgery |
19 | 1387 | Risk Ratio (M-H, Random, 95% CI) | 0.96 [0.87, 1.06] |
| 2.1 Cardiac | 15 | 1196 | Risk Ratio (M-H, Random, 95% CI) | 0.95 [0.84, 1.07] |
| 2.2 Miscellaneous | 4 | 191 | Risk Ratio (M-H, Random, 95% CI) | 1.01 [0.81, 1.26] |
| 3 No. exposed to allogeneic blood - Cardiac surgery |
15 | 1196 | Risk Ratio (M-H, Random, 95% CI) | 0.95 [0.84, 1.07] |
| 3.1 Primary CABG surgery | 9 | 586 | Risk Ratio (M-H, Random, 95% CI) | 0.85 [0.73, 0.99] |
| 3.2 CABG + valve +/− combination / redo surgery |
6 | 610 | Risk Ratio (M-H, Random, 95% CI) | 1.03 [0.88, 1.19] |
| 4 No. exposed to allogeneic blood - Cardiac surgery - ASA use |
10 | 685 | Risk Ratio (M-H, Random, 95% CI) | 0.84 [0.69, 1.01] |
| 4.1 ASA use within 7 days prior to surgery |
6 | 399 | Risk Ratio (M-H, Random, 95% CI) | 0.89 [0.64, 1.23] |
| 4.2 No ASA use within 7 days of surgery |
4 | 286 | Risk Ratio (M-H, Random, 95% CI) | 0.79 [0.62, 1.01] |
| 5 No. exposed to allogeneic blood - Transfusion protocol |
19 | 1387 | Risk Ratio (M-H, Random, 95% CI) | 0.96 [0.87, 1.06] |
| 5.1 Transfusion Protocol | 10 | 736 | Risk Ratio (M-H, Random, 95% CI) | 0.90 [0.77, 1.04] |
| 5.2 No Transfusion Protocol | 9 | 651 | Risk Ratio (M-H, Random, 95% CI) | 1.03 [0.93, 1.14] |
| 6 No. exposed to allogeneic blood - Use of autologous techniques (ANH, PAD, CS) |
19 | 1387 | Risk Ratio (M-H, Random, 95% CI) | 0.96 [0.87, 1.06] |
| 6.1 No autologous techniques used |
10 | 732 | Risk Ratio (M-H, Random, 95% CI) | 0.91 [0.78, 1.07] |
| 6.2 Autologous technique/s used (ANH, PAD, CS) |
9 | 655 | Risk Ratio (M-H, Random, 95% CI) | 1.00 [0.84, 1.19] |
| 7 Trial quality - Allocation concealment (Cochrane scale) | 19 | 1387 | Risk Ratio (M-H, Random, 95% CI) | 0.96 [0.87, 1.06] |
| 7.1 Quality A | 3 | 249 | Risk Ratio (M-H, Random, 95% CI) | 0.97 [0.75, 1.24] |
| 7.2 Quality B | 11 | 766 | Risk Ratio (M-H, Random, 95% CI) | 0.88 [0.75, 1.03] |
| 7.3 Quality C | 5 | 372 | Risk Ratio (M-H, Random, 95% CI) | 1.11 [0.94, 1.33] |
| 8 Units of blood transfused - All patients |
14 | 885 | Mean Difference (IV, Random, 95% CI) | −0.30 [−0.60, −0.01] |
| 9 Units of blood transfused - Type of surgery |
14 | 885 | Mean Difference (IV, Random, 95% CI) | −0.30 [−0.60, −0.01] |
| 9.1 Cardiac | 10 | 621 | Mean Difference (IV, Random, 95% CI) | −0.39 [−0.77, −0.01] |
| 9.2 Orthopaedic | 2 | 129 | Mean Difference (IV, Random, 95% CI) | −0.15 [−0.64, 0.33] |
| 9.3 Vascular | 2 | 135 | Mean Difference (IV, Random, 95% CI) | 0.06 [−0.89, 1.02] |
| 10 Units of blood transfused - All patients - Use of autologous techniques (ANH, PAD, CS) |
14 | 885 | Mean Difference (IV, Random, 95% CI) | −0.30 [−0.60, −0.01] |
| 10.1 No autologous techniques used |
10 | 734 | Mean Difference (IV, Random, 95% CI) | −0.22 [−0.55, 0.10] |
| 10.2 Autologous technique/s used (ANH, PAD, CS) |
4 | 151 | Mean Difference (IV, Random, 95% CI) | −0.47 [−1.15, 0.20] |
| 11 Units of blood transfused - In those transfused |
5 | 211 | Mean Difference (IV, Random, 95% CI) | −0.49 [−0.94, −0.04] |
| 12 Blood loss - All surgery | 22 | 2363 | Mean Difference (IV, Random, 95% CI) | −113.05 [−160.27, − 65.84] |
| 12.1 Intra-operative blood loss |
7 | 493 | Mean Difference (IV, Random, 95% CI) | −90.07 [−199.56, 19. 42] |
| 12.2 Post-operative blood loss | 18 | 1201 | Mean Difference (IV, Random, 95% CI) | −92.98 [−149.86, − 36.11] |
| 12.3 Total blood loss - intra+post-operative blood loss |
10 | 669 | Mean Difference (IV, Random, 95% CI) | −241.78 [−387.55, − 96.01] |
| 13 Blood loss - All surgery (time period) |
22 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 13.1 Intra-operative blood loss |
7 | 493 | Mean Difference (IV, Random, 95% CI) | −90.07 [−199.56, 19. 42] |
| 13.2 0-6 hours post-operative blood loss |
1 | 59 | Mean Difference (IV, Random, 95% CI) | −98.0 [−304.99, 108. 99] |
| 13.3 0-12 hours post operative blood loss |
3 | 233 | Mean Difference (IV, Random, 95% CI) | −114.05 [−269.46, 41.36] |
| 13.4 0-16 hours post operative blood loss |
2 | 122 | Mean Difference (IV, Random, 95% CI) | −18.01 [−113.34, 77. 32] |
| 13.5 0-24 hours post operative blood loss |
12 | 787 | Mean Difference (IV, Random, 95% CI) | −100.41 [−176.48, − 24.34] |
| 13.6 Total blood loss - intra+post-operative blood loss |
10 | 669 | Mean Difference (IV, Random, 95% CI) | −239.02 [−388.58, − 89.46] |
| 14 Blood loss - Cardiac surgery | 18 | 1832 | Mean Difference (IV, Random, 95% CI) | −116.81 [−172.63, − 60.99] |
| 14.1 Intra-operative blood loss |
3 | 229 | Mean Difference (IV, Random, 95% CI) | −119.79 [−314.57, 75.00] |
| 14.2 Post-operative blood loss | 16 | 1107 | Mean Difference (IV, Random, 95% CI) | −96.58 [−163.04, − 30.12] |
| 14.3 Total blood loss - intra+post-operative |
7 | 496 | Mean Difference (IV, Random, 95% CI) | −237.92 [−413.43, − 62.40] |
| 15 Blood loss (Post-operative) - Cardiac surgery - ASA use |
13 | 854 | Mean Difference (IV, Random, 95% CI) | −108.10 [−175.60, − 40.60] |
| 15.1 ASA use within 7 days prior to surgery |
10 | 633 | Mean Difference (IV, Random, 95% CI) | −109.57 [−200.11, − 19.03] |
| 15.2 No ASA use within 7 days of surgery |
3 | 221 | Mean Difference (IV, Random, 95% CI) | −112.69 [−227.59, 2. 22] |
| 16 Blood loss - Cardiac surgery (time period) |
18 | Mean Difference (IV, Random, 95% CI) | Subtotals only | |
| 16.1 Intra-operative blood loss |
3 | 229 | Mean Difference (IV, Random, 95% CI) | −119.79 [−314.57, 75.00] |
| 16.2 0-6 hours post-operative blood loss |
1 | 59 | Mean Difference (IV, Random, 95% CI) | −98.0 [−304.99, 108. 99] |
| 16.3 0-12 hours post operative blood loss |
3 | 233 | Mean Difference (IV, Random, 95% CI) | −114.05 [−269.46, 41.36] |
| 16.4 0-16 hours post operative blood loss |
2 | 122 | Mean Difference (IV, Random, 95% CI) | −18.01 [−113.34, 77. 32] |
| 16.5 0-24 hours post operative blood loss |
10 | 693 | Mean Difference (IV, Random, 95% CI) | −107.46 [−207.12, − 7.80] |
| 16.6 Total blood loss - intra+post-operative blood loss |
7 | 496 | Mean Difference (IV, Random, 95% CI) | −237.92 [−413.43, − 62.40] |
| 17 Blood loss - Post-operative blood loss by CPB times |
15 | 1024 | Mean Difference (IV, Random, 95% CI) | −93.34 [−162.24, − 24.44] |
| 17.1 Less than 80 minutes | 3 | 198 | Mean Difference (IV, Random, 95% CI) | −41.22 [−157.25, 74. 80] |
| 17.2 Between 80-100 minutes | 5 | 330 | Mean Difference (IV, Random, 95% CI) | −104.18 [−184.75, − 23.61] |
| 17.3 Between 101-120 minutes |
3 | 129 | Mean Difference (IV, Random, 95% CI) | 53.08 [−156.33, 262. 50] |
| 17.4 Between 121-140 minutes |
2 | 196 | Mean Difference (IV, Random, 95% CI) | −46.53 [−366.29, 273.23] |
| 17.5 Greater than 140 minutes |
2 | 171 | Mean Difference (IV, Random, 95% CI) | −344.74 [−478.50, − 210.97] |