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PubMed1989

Measurements of 6-keto-prostaglandin F1 alpha and thromboxane B2 in bleeding time blood: relation to bleeding and vascular disorders?

The body's ability to produce prostacyclin and thromboxane by blood vessels and platelets may be important in hemostatic and thrombotic disorders and in blood pressure regulation. There are limitations to the information that can be derived from measurement of the active substances or metabolites in plasma and urine. Assays for thromboxane and prostacyclin in bleeding time blood reflect production in response to a single standardized vascular injury, and show considerable promise in furthering our understanding of the production of these chemicals in vivo. These assays may improve the assessment of risk of developing thrombotic disorders and improve the ability to monitor treatment. Studies to date have focused largely on the influences of various doses of aspirin on the production of prostacyclin and thromboxane in bleeding time blood, but also suggest that smokers are high thromboxane producers. In addition, individuals who exhibit type A behavior, a behavior pattern characterized by a relatively high level of ambitiousness, hostility, and competitive drive and a chronic sense of urgency appear to be low prostacyclin producers. Diets enriched in sunflower oil were found to diminish thromboxane production, while diets high in canola oil enhanced prostacyclin formation.

6-Ketoprostaglandin F1 alpha↗
PubMed1981

Acetylsalicylic acid-induced prolongation of bleeding time in healthy men.

Bleeding times were determined in 25 healthy men using the Thrombolette bleeding time device. The median bleeding times prior to low and high doses of acetylsalicylic acid (ASA), 245 and 230 s, were not significantly different (P = 0.12). 2 h after randomized ingestion of 0.44 and 3.96 g ASA, the median bleeding times rose to 450 and 430 s, respectively. Both increased in bleeding time were significant (P less than 0.001), but the difference was not significant (P = 0.29). The maximum increase in bleeding time was estimated to occur 2.6 h after ingestion of a single low ASA dose, and 2.4 h after a single high dose. Following ingestion of 0.44 as well as 3.96 g ASA the bleeding time returned to basal levels within 5-6 d. Compared to the younger ones, volunteers with a higher age showed a tendency to have lower plasma salicylate levels as well as smaller increases in bleeding times following ASA ingestion.

Adult↗
PubMed1991

The bleeding time.

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Bleeding Time↗
PubMed2002

Relationship between bleeding time test and postextraction bleeding in a healthy control population.

OBJECTIVE: We sought to determine whether cutaneous bleeding time (BT) is related to bleeding outcome measures after a single tooth extraction. STUDY DESIGN: This was a prospective clinical pilot study of 30 subjects. Cutaneous BT was evaluated before a single tooth extraction. After extraction, an oral BT was determined. Subjects were contacted 3 to 7 hours and 2 days after extraction to assess further postoperative bleeding. RESULTS: The mean cutaneous BT was 5.9 minutes (range 1.5-10.0 minutes). The mean oral BT was 7.5 minutes (range 0-20 minutes). Cutaneous BT did not correlate with oral BT or any of our measures of postoperative bleeding. However, the oral BT correlated with the number of hours of bleeding after surgery (R(s) = 0.54, P =.03). The time necessary to perform the extraction correlated with the extraction site bleeding 3 to 7 hours after surgery (R(s) = 0.67, P =.0006). CONCLUSION: Cutaneous BT did not correlate with measures of postoperative bleeding in the present study, but oral BT immediately after extraction correlated with the duration of subsequent postoperative bleeding.

Adult↗
PubMed1996

Reversible prolonged skin bleeding time in acute gastrointestinal bleeding presumed due to NSAIDs.

The purpose of this research was to look for a possible mechanism whereby NSAIDs, and particularly ASA, might cause gastrointestinal bleeding. A total of 34 hospitalized GI bleeders and 29 age- and sex-matched controls were studied. Skin bleeding time (SBT) was measured within 6 h of coming to hospital and before any blood products were given. All patients and controls were questioned regarding current NSAID use. This history was supplemented by estimation of serum salicylate and of platelet cyclooxygenase activity to detect unreported current aspirin (ASA) use. Various aspects of platelet function were also tested by lumiaggregation in 28 controls and, after recovery, in 27 of the bleeders. Of 34 bleeders, 26 bled from the upper GI tract, (13 from peptic ulcer) and eight from the lower GI tract, 30 (88%) had a current intake of NSAIDs and of these 22 (73%) used ASA, some in combination with other NSAIDs, whereas 12 of 29 controls were using NSAID's, 11 of which were ASA. SBT in the bleeders was 9.0 +/- 1.02 min versus 4.8 +/- 0.42 min in the controls (p < 0.001). SBT measured 6.6 days later in 28 bleeders was 4.7 +/- 0.22 min (p < 0.0006), and of those tested after recovery all but one had fallen to 6.5 min or less. None had any residual constitutional platelet abnormalities as tested by lumiaggregation. By logistic regression, NSAID intake was strongly associated with prolonged SBT to > 6 min (odds ratio [OR], 16.7; p < 0.0002), whereas NSAID intake (OR 14.6; p < 0.0003) and SBT > 6 min (OR 1.8; p < 0.005) contributed to a bleeding outcome. Almost 90% of GI bleeders had recently consumed NSAIDs, mostly ASA, on an average 15 h before onset of bleeding. Although most of the nonbleeders who had used NSAIDs did not have a prolonged SBT, most of the bleeders who used NSAIDs had an abnormal elevation of SBT, suggesting a possible mechanism for GI bleeding. Retesting approximately 7 days after recovery from bleeding showed normalization of the SBT, indicating that the defect was transient and spontaneously reversible.

Acute Disease↗
PubMed1976

[A new standardized method for determination of the bleeding time].

The standardized bleeding time is considered a valuable measure of the platelet role in haemostasis. It is particularly useful for the evaluation of drugs that affect platelet functions. Measurements of the bleeding time were performed using a new system which was designed following the instructions of Mielke and co-workers with some variations of the described method. The standardized bleeding time proved to be a high reproducible and sensitive technique.

Animals↗
PubMed1983

Influence of aspirin on platelets and the bleeding time.

Aspirin influences the bleeding time, presumably through the inhibition of prostaglandin biosynthesis and the resultant platelet secretion reaction. This can be measured by prolongation of the bleeding time and changes in platelet function results. Despite these changes, bleeding is rarely a problem in patients who have normal hemostatic mechanisms. To investigate this, we have studied the technical variables associated with the determination of the bleeding time. Both venostasis and direction of the incision play a major role in the bleeding time prolongation induced by aspirin. When a bleeding time determination is performed with vertical incision without venostasis, there is almost no detectable prolongation of the bleeding time. These studies support our previous observations that aspirin has a mild influence on primary hemostasis.

Animals↗
PubMedDate not supplied

Gastric mucosal bleeding time in cirrhosis.

Gastric mucosal bleeding time was measured prospectively in 25 patients with cirrhosis and portal hypertension undergoing routine sclerotherapy. Age and sex-matched controls without liver disease were also studied. Correlations were sought between gastric mucosal bleeding time and age, platelet count, prothrombin time, skin bleeding time, Child-Pugh score, variceal size before sclerotherapy, and degree of portal hypertensive gastropathy. Gastric bleeding time was prolonged in 12% of the patients with cirrhosis (mean, 3.24 minutes; SEM, 0.476) and in none of the controls (mean, 3.0; SEM, 0.171). No correlation was noted between gastric bleeding time and any of the above variables. The results of this study indicate that gastric mucosal bleeding time is prolonged in cirrhosis but is an independent physiologic parameter unrelated to any of the above-mentioned variables.

Bleeding Time↗
PubMed1983

The effects of mezlocillin, ticarcillin and placebo on blood coagulation and bleeding time in normal volunteers.

Bleeding time, coagulation tests and platelet aggregation response to adenosine diphosphate (ADP), epinephrine, arachidonic acid, ristocetin and collagen were determined in 18 normal male volunteers in a randomized, double-blind, placebo-controlled parallel study. Six subjects each received either placebo or 4.0 g of either mezlocillin or ticarcillin every 6 h for 7 days. In the placebo-treated or mezlocillin-treated groups no changes in plasma coagulation tests or bleeding time were observed. Randomly scattered decreases in platelet aggregation responses to ADP, epinephrine or arachidonic acid were noted in some subjects in both the placebo and mezlocillin groups. In contrast to these observations, in the ticarcillin treated group the bleeding time was abnormally prolonged to more than 18 min in three of six volunteers. In two of these subjects, bleeding time was prolonged after only seven ticarcillin doses (28.0 g) and in the third subject after a total of 21 doses (84.0 g). A significant decrease in platelet aggregation (P less than 0.005) induced by ADP was found in these volunteers. Although platelet aggregation response to arachidonic acid and epinephrine also appeared to be reduced in this group, correlation between increased bleeding time and abnormal platelet function was not possible because of the small number of subjects. No changes in other coagulation function were observed. The results suggest that the risk of bleeding disorder is very high with therapeutic doses of ticarcillin but not with comparable doses of mezlocillin.

Adolescent↗
PubMed1995

The effect of magnesium sulfate on bleeding time in pregnancy.

OBJECTIVE: The bleeding time is one of the most commonly used diagnostic tests to evaluate platelet-related hemorrhagic disorders. Magnesium has been shown in vitro to be a platelet antiaggregant. This study was conducted to evaluate the hypothesis that magnesium sulfate has no effect on the template bleeding time. STUDY DESIGN: The study group consisted of 24 women who required magnesium sulfate in pregnancy. A blood cell count, platelet count, magnesium level, bleeding time, and mean arterial pressure were obtained before and 2 hours after magnesium sulfate infusion. Magnesium sulfate was infused beginning with a 6 gm intravenous bolus followed by 2 gm/hr. A template bleeding time was performed with a Simplate-II (Organon Teknika, Durham, N.C.) device. Two of the authors performed all the bleeding times. Data were analyzed with a paired t test and Wilcoxon rank test. RESULTS: Fifteen (63%) patients received magnesium sulfate for tocolysis or before external cephalic version and nine (37%) for preeclampsia prophylaxis. No differences were found between the normotensive and hypertensive groups regarding maternal age, gestational age, initial bleeding time, or platelet count. Analysis of the entire study group revealed a prolongation of the bleeding time after magnesium sulfate (5.7 +/- 1.8 vs 6.6 +/- 1.9 minutes, p < 0.05); a lowering of the mean arterial pressure (p < 0.05), and a rise in the magnesium level (p < 0.05). Four patients (16.7%) had a postmagnesium bleeding time > 9 minutes. CONCLUSION: Magnesium sulfate appears to prolong the bleeding time in pregnancy. The clinical significance remains to be determined.

Adult↗
PubMed1984

Intranasal deamino-8-D-arginine vasopressin shortens the bleeding time in uremia.

Clinical bleeding in uremia is a frequent problem and seems to correlate with a prolonged bleeding time. The vasopressin analog deamino-8-D-arginine vasopressin has been shown to shorten the bleeding time and to decrease clinical bleeding when administered intravenously to uremic patients. In the present study we administered the readily available intranasal deamino-8-D-arginine vasopressin to 2 uremic patients and demonstrated a decreased bleeding time and improvement in clinical bleeding.

Administration, Intranasal↗
PubMed1978

Development and evaluation of a disposable device for performing simultaneous duplicate bleeding time determinations.

A disposable bleeding time device that provides two simultaneous standardized incisions is described. The mean bleeding time of 47 normal adults was 4.1 min with a 95% range of 2.2--7.0 min. The standard deviation of duplicate bleeding times was 0.7 min, and the day-to-day standard deviation for individuals was 0.9 min. In a double-blind crossover study of 20 normal adults, the mean bleeding time increased from 3.7 to 6.2 min after ingestion of 1 g aspirin. The device is extremely simple to use and is essentially painless. Physical trauma is minimal.

Aspirin↗
PubMed1990

Usefulness of the bleeding time to predict the risk of clinical bleeding in patients with uraemia.

In a prospective study of haemostatic status of 15 uraemic Nigerians a highly significant prolongation of bleeding time (p less than 0.001) and significantly lower haematocrit levels (p less than 0.001) were detected in comparison to healthy controls. A highly significant positive correlation (r = +0.778) between prolongation of bleeding time and blood urea was present. Six patients had overt clinical bleeding with significantly prolonged bleeding time (p less than 0.01) compared to uraemics without overt bleeding. Blood urea was significantly different in both groups (p greater than 0.1). Platelet count, prothrombin time, partial thromboplastin time and Hess tourniquet test did not differ between the uraemic patients and controls. Haemostatic dysfunction has been noted in Nigerian uraemics we studied. Bleeding time is a useful but simple means of assessing such dysfunction.

Adolescent↗