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Desmopressin + protamine is a therapeutic combination used to manage intraoperative bleeding, specifically in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Protamine sulfate is administered to neutralize the systemic anticoagulation induced by heparin during CPB by forming an inactive salt complex. Desmopressin (DDAVP), a synthetic analog of vasopressin, is subsequently administered to enhance hemostasis by stimulating the release of von Willebrand factor (vWF) and coagulation factor VIII from endothelial cells. This dual approach addresses both the reversal of anticoagulation and the improvement of platelet function, which is often impaired following CPB. The combination is studied for its ability to reduce postoperative blood loss and the need for blood product transfusions.
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