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Vol. 63. Issue 2.
Pages 115-119 (March - April 2012)
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Vol. 63. Issue 2.
Pages 115-119 (March - April 2012)
Original Article
Use of Desmopressin in Children With Inherited Platelet Dysfunctions Undergoing Adenotonsillar Procedures
Uso de desmopresina en niños con disfunción plaquetaria congénita sometidos a adeno y/o amigdalectomía
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Raimundo J. García-Mattea, M. Constanza Beltranb, Ximena Fonsecab, Francisco Barrigac, Angélica Wietstruckc, Pamela Zúñigac,
Corresponding author
a Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
b Departamento de Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
c Departamento de Hematología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Table 1. Haemostasis Protocol Used at Our Centre for Children With Mild Platelet Dysfunction Undergoing Surgical Procedures.
Abstract
Introduction and goals

Adenotonsillar surgery represents a major haemostatic challenge in paediatric patients with mild inherited platelet dysfunction. While there are recommendations for perioperative haemostatic management, there are no reports of the outcomes with the different recommendations in these children when undergoing adenotonsillectomy. Our objective was to evaluate the management of perioperative bleeding with desmopressin in children with mild platelet dysfunctions who underwent adenotonsillar surgery in our hospital.

Methods

We performed a retrospective study aimed at determining the perioperative bleeding and complication rate in children with mild inherited platelet dysfunction in whom desmopressin was used while undergoing adenotonsillar procedures.

Results

Between 2004 and 2010, 27 children with mild inherited platelet dysfunction underwent adenotonsillar procedures in our hospital and were treated with desmopressin. One patient developed perioperative bleeding (3.7%) and there was 1 child (3.7%) who presented transitory hypotension as a side effect of desmopressin.

Conclusions

The use of desmopressin allowed adequate perioperative bleeding prophylaxis management in children with mild inherited platelet dysfunction who underwent adenotonsillar procedures without presenting severe complications.

Keywords:
Adenoidectomy
Tonsillectomy
Platelet function disorders
Surgical haemorrhage
Children
Resumen
Introducción y objetivos

La cirugía de adenoides y/o amígdalas representa un desafío hemostático importante en pacientes pediátricos con disfunción plaquetaria congénita leve. Si bien existen recomendaciones para el manejo perioperatorio de la hemostasia en estos pacientes, no hay informes de resultados del manejo con las distintas recomendaciones en niños sometidos a cirugía adenoamigdalina. Nuestro objetivo es evaluar el uso de desmopresina para la prevención de la hemorragia perioperatoria en niños con disfunción plaquetaria congénita leve sometidos a adeno y/o amigdalectomía en nuestro centro.

Métodos

Estudio retrospectivo descriptivo dirigido a determinar la tasa de hemorragia perioperatoria y complicaciones en niños con disfunción plaquetaria congénita leve en quienes se utilizó desmopresina cuando fueron sometidos a adeno y/o amigdalectomía.

Resultados

Entre los años 2004 y 2010, 27 niños con disfunción plaquetaria congénita leve fueron sometidos a cirugía de adenoides y/o amígdalas y recibieron desmopresina. Un paciente (3,7%) desarrolló hemorragia perioperatoria. Se registró un caso (3,7%) de hipotensión transitoria como efecto adverso atribuible a la desmopresina.

Conclusiones

El uso de desmopresina permitió un buen manejo preventivo de la hemorragia perioperatoria en pacientes con disfunción plaquetaria congénita leve sometidos a adenoamigdalectomía, sin presentar complicaciones graves.

Palabras clave:
Adenoidectomía
Amigdalectomía
Disfunciones plaquetarias
Hemorragia quirúrgica
Niños

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