Desmopressin for prevention of bleeding for thrombocytopenic, critically ill patients undergoing invasive procedures: A randomised, double‐blind, placebo‐controlled feasibility trial
Michael J. R. Desborough,
Emma Laing,
Daphne Kounali,
Ana Mora,
Renate Hodge,
Siobhan Martin,
Helen Thomas,
Cara Hudson,
Joseph Parsons,
Akshay Shah,
Paula Hutton,
Tim Parke,
Matthew P. Wise,
Matthew Morgan,
Stuart McKechnie,
Simon J. Stanworth
Affiliations
Michael J. R. Desborough
Department of Clinical Haematology Oxford University Hospitals NHS Foundation Trust Oxford UK
Emma Laing
NHS Blood and Transplant Clinical Trials Unit Cambridge UK
Daphne Kounali
NHS Blood and Transplant Clinical Trials Unit Bristol UK
Ana Mora
NHS Blood and Transplant Clinical Trials Unit Cambridge UK
Renate Hodge
NHS Blood and Transplant Clinical Trials Unit Cambridge UK
Siobhan Martin
NHS Blood and Transplant Clinical Trials Unit Cambridge UK
Helen Thomas
NHS Blood and Transplant Clinical Trials Unit Bristol UK
Cara Hudson
NHS Blood and Transplant Clinical Trials Unit Bristol UK
Joseph Parsons
NHS Blood and Transplant Clinical Trials Unit Bristol UK
Akshay Shah
Department of Critical Care Oxford University Hospitals NHS Foundation Trust Oxford UK
Paula Hutton
Department of Critical Care Oxford University Hospitals NHS Foundation Trust Oxford UK
Tim Parke
Department of Critical Care Royal Berkshire Hospital Reading UK
Matthew P. Wise
Department of Critical Care University Hospital of Wales Cardiff UK
Matthew Morgan
Department of Critical Care University Hospital of Wales Cardiff UK
Stuart McKechnie
Department of Critical Care Oxford University Hospitals NHS Foundation Trust Oxford UK
Simon J. Stanworth
Department of Clinical Haematology Oxford University Hospitals NHS Foundation Trust Oxford UK
Abstract Thrombocytopenic 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.
