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Easy bruisability, aspirin intolerance, and response to DDAVP®
Author(s) -
Lekas Mary D.,
Crowley James P.
Publication year - 1993
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.5541030206
Subject(s) - aspirin , medicine , desmopressin , bleeding time , anesthesia , hemostasis , surgery , platelet , platelet aggregation
Easy bruisability raises the issue of bleeding during otolaryngological surgery. Ten female patients with easy bruisability were evaluated by aspirin challenge; clinical history and screening coagulation studies in these patients had revealed no evidence of a bleeding disorder. The baseline Ivy bleeding time (BT) test (4.5 to 9.5 minutes) was found to be normal in 6 patients and prolonged in 4 patients. Following treatment with aspirin, the bleeding time prolonged significantly in the three groups evaluated: normal controls (6.0 ± 1.5 minutes vs. 8.4 ± 2.0 minutes), patients with easy bruisability and a normal baseline (7.8 ± 1.3 minutes vs. 12.0 ± 1.6 minutes), and patients with easy bruisability and an abnormal baseline (11.0 ± 0.7 minutes vs. 14.5 ± 0.9 minutes). Administration of DDAVP® (desmopressin acetate) 0.3 μg/kg normalized the prolonged bleeding times in all groups after 7 days of daily aspirin therapy. Performing bleeding times before aspirin challenge, after aspirin challenge, and after DDAVP therapy following aspirin challenge is both a useful way of confirming aspirin sensitivity in patients with easy bruisability as well as a useful way of documenting improved hemostasis after DDAVP administration.