Desmopressin for Antiplatelet-Associated Intracranial Hemorrhage: A Concise Review

OBJECTIVE: To provide a concise review of the literature on desmopressin use for antiplatelet reversal in patients with intracranial hemorrhage. DATA SOURCES: Source data were obtained from a PubMed literature review. STUDY SELECTION: Studies addressing desmopressin for antiplatelet reversal. DATA EXTRACTION: Relevant studies were reviewed and included through consensus of the authors. The following aspects of each study were identified, abstracted, and analyzed: study population, study design, methods, results, and relevant implications for practice. DATA SYNTHESIS: A growing body of evidence continues to provide mixed results for the use of desmopressin in patients presenting with antiplatelet-associated intracranial hemorrhage. The potential benefit outweighs the possible risks associated with a one-time dose. In addition to desmopressin, platelets should only be considered in patients undergoing a neurosurgical procedure until further and superior evidence is available. Guidelines recommend a weight-based approach for desmopressin dosing at 0.4 mcg/kg over 30 min. CONCLUSIONS: The available evidence supports desmopressin as potentially beneficial with minimal risk for use in patients with antiplatelet-associated intracranial hemorrhage.