Document Detail

Anemia-induced increase in the bleeding time: implications for treatment of nonsurgical blood loss.
MedLine Citation:
PMID:  11493727     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Preoperative bleeding time (BT) does not correlate with postoperative bleeding in patients subjected to surgical procedures. A significant positive correlation has been reported between the BT 2 hours after cardiopulmonary bypass surgery and the nonsurgical blood loss during the first 4 hours after bypass surgery. This study was done to investigate the effect of Hct and platelet count on the BT measurement in normal, healthy men and women. STUDY DESIGN AND METHODS: To assess the relative effect of RBCs and platelets on the BT, 22 healthy male and 7 healthy female volunteers were subjected to the removal of 2 units of RBCs (360 mL), followed by the return of the platelet-rich plasma (PRP) from both units and the infusion of 1000 mL of 0.9-percent NaCl. Four of the men and all seven women received their RBCs 1 hour after their removal. Shed blood levels of thromboxane B(2) (TXB(2)), 6-keto prostaglandin F(1 alpha), and peripheral venous Hct were measured. BTs were measured in 15 men and 13 women before and after a plateletpheresis procedure to collect 3.6 x 10(11) platelets per unit. RESULTS: The 2-unit RBC apheresis procedure produced a 60-percent increase in the BT associated with a 15-percent reduction in the peripheral venous Hct and a 9-percent reduction in the platelet count. The plateletpheresis procedure produced a 32-percent decrease in the platelet count, no change in peripheral venous Hct, and no change in the BT. After the removal of 2 units of RBCs, the shed blood TXB(2) level decreased significantly. Reinfusion of 2 units of RBCs restored the BT and restored the TXB(2) level to the baseline levels. CONCLUSION: The acute reduction in Hct produced a reversible platelet dysfunction manifested by an increase in BT and a decrease in the shed blood TXB(2) level at the template BT site. Return of the RBCs restored both the BT and the shed blood TXB(2) level to normal. The platelet dysfunction observed with the reduction in Hct was due in part to a reduction in shed blood TXB(2) and other, unknown mechanisms.
C R Valeri; G Cassidy; L E Pivacek; G Ragno; W Lieberthal; J P Crowley; S F Khuri; J Loscalzo
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Transfusion     Volume:  41     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-08     Completed Date:  2001-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  977-83     Citation Subset:  IM    
Naval Blood Research Laboratory, Boston University School of Medicine, Massachusetts 02118, USA.
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MeSH Terms
Analysis of Variance
Anemia / blood*,  complications
Bleeding Time*
Blood Component Removal
Erythrocyte Transfusion
Hemorrhage / etiology,  therapy*
Platelet Count
Thromboxane B2 / blood
Reg. No./Substance:
54397-85-2/Thromboxane B2

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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