Summary
The occlusion time (“haemostasis time” — HT) of a thin, short cannula inserted into the cubital vein, was compared with the skin bleeding times of the Duke and Ivy/template techniques. 25 male and 25 female volunteers without a history of bleeding were divided into 5 equally large age groups ranging from 10 to over 50 years of age. They exhibited a range of 46 s–6 min 38 s (95% tolerance interval), while the Duke and Ivy/template bleeding times, which were simultaneously determined, corresponded to values given by other authors.
HT is different from the skin bleeding times in that endothelium is replaced by a standard foreign surface which allows better standardization of the method. Similar results were obtained with HT compared to the skin bleeding times. These and a similar, non-significant heparin response with all three techniques suggest that HT is not more influenced by clotting factors than the Duke and Ivy/template bleeding times and, indeed, may be regarded as a bleeding time modification. HT, like both of the skin bleeding times, reflected lowered platelet counts and is even more sensitive in this respect. As tested in a group of 20 male and 20 female volunteers, HT showed a significant prolongation two hours after ingestion of 1 g aspirin. While male individuals exhibited longer bleeding times than females with the Ivy/template technique (sex-related difference p=0.01), no male to female differences were found both with HT and the Duke bleeding time.
HT is easy to perform, inexpensive, leaves no scars and is safe even for the patient with severe bleeding. Moreover, compared to the skin bleeding times, it permits a differential evaluation of vessel wall and tissue effects.
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References
Borchgrevink CF, Waaler BA (1958) The secondary bleeding time. A new method for the differentiation of haemorrhagic diseases. Acta Med Scand 162: 361–374
Borchgrevink CF (1971) Bleeding time techniques. In: Bang NU, Beller FK, Deutsche E, Mammen EF (eds) Thrombosis and Bleeding Disorders. Thieme Stuttgart, Academic Press New York, London, pp 426–428
Bowie EJW, Owen jr CA (1974) The bleeding time. Prog Hemost Thromb 2: 249–271
Bowie EJW, Owen jr CA (1981) Test of platelte function. Vox Sang 40 (suppl 1): 36–47
Chan TK, Chan V (1979) The effect of venous occlusion on anti-thrombin III, plasminogen activator and fibrinogen degradation product (fragment E) levels. Thromb Res 14: 525–534
Copley AL, Lalich JJ (1942) Bleeding time, lymph time, and clot resistance in men. J Clin Invest 21: 145–152
Copley AL (1974) Bleeding time, other in vivo haemostasis tests and the arrest of hemorrhage. Thromb Res 4: 1–23
Duke WW (1910) The relation of blood platelets to hemorrhagic disease. JAMA 55: 1185–1192
Feusner JH (1980) Normal and abnormal bleeding times in neonates and young children utilizing a fully standardized template technique. Am J Clin Pathol 74: 73–77
Göbel U, von Voss H, Jürgens H, Lauber A, Volkmer HP (1978) The reproductiveness of bleeding time tests. Minerva Pediatr 30: 1391–1396
Harker LA, Slichter SJ (1972) The bleeding time as a screening test for evaluation of platelet function. N Engl J Med 287: 155–158
Hartert H (1971) Thrombelastography. In: Bang NU, Beller FK, Deutsch E, Mammen EF (eds) Thrombosis and Bleeding Disorders. Thieme Stuttgart, Academic Press NY London, pp 70–76
Heiden D, Mielke CH, Rodvien R (1977) Impairment by heparin of primary haemostasis and Platelet (14c)5-Hydroxytryptamine Release. Br J Haematol 36: 427–436
Hellem AJ, Borchgrevink CF, Ames SB (1961) The role of red cells in haemostasis: the relation between haematocrit, bleeding time and platelet adhesiveness. Br J Haematol 7: 42–50
Hirsh J, Blajchman M, Kaegi A (1978) The bleeding time. In: Day HJ, Holmsen H, Zucker MB (eds) Platelet Function Testing, U.S. Department of Health, Education, and Welfare, pp 1–12
Ivy AC, Shapiro PF, Melnick P (1935) The bleeding tendency in jaundice. Surg Gynecol Obstet 60: 781–784
Janzarik H, Remy S (1985) “Haemostasis time” (HT), a bleeding time modification. (Abstract). Thromb Haemost 54: 152
Kumar R, Ansell J, Canoso RT, Deykin D (1978) Clinical trial of a new bleeding-time device. Am J Clin Pathol 70: 642–645
Mielke CH, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SI (1969) The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood 34: 204–215
Mielke CH jr (1978) Template bleeding time: technical evaluation and comparison to other methods in normal adults. In: Day HJ, Holmsen H, Zucker MB (eds) Platelet Function Testing. Department of Health, Education, and Welfare, pp 13–20
Mielke CH (1984) Measurement of the bleeding time. Thromb Haemost 52: 210–211
Nilsson IM, Magnusson S, Borchgrevink C (1963) The Duke and Ivy methods for determination of the bleeding time. Thromb Diathes Haemorrh 10: 223–234
Praga C, Valentini L, Maiorano M (1978) Standardized bleeding time with a new automatic device. In: Day HJ, Holmsen H, Zucker MB (eds) Platelet Function Testing. Department of Health, Education, and Welfare, pp 23–28
Quick AJ (1976) The Duke bleeding time. Am J Clin Pathol 47: 459–465
Quick AJ (1975) The bleeding time as a test of hemostatic function. Am J Clin Pathol 64: 87–94
Roper-Drewinko PR, Drewinko B, Corrigan G, Johnston D, Mc Credie KB, Freireich EJ (1981) Standardization of platelet function tests. Am J Haematol 11: 183–203
Sutor AH, Hoever C (1980) Intravenöse Blutungszeit (VBZ). Ein neuer in vivo-Test zur Beurteilung der zellulären Hämostase. In: Deutsch E, Lechner K (eds) Fibrinolyse, Thrombose, Hämostase. Schattauer, Stuttgart New York, pp 367–370
Sutor AH, Skrzipcyk N, Hoever C, Schellong G (1982) Venöse Blutungszeit (VBZ) bei Leukosen im Kindesalter. In: van de Loo J, Asbeck F (eds) Haemostase, Thrombophilie und Arteriosklerose. Schattauer, Stuttgart New York, pp 344–347
Thomas R, Hessel EA, Dillard DH, Harker LA (1979) Standardized template bleeding time in dogs. J Surg Res 27: 244–249
Young VP, Giles AR, Pater J, Corbett EN (1980) Sex differences in bleeding time and blood loss in normal subjects following aspirin ingestion. Thromb Res 20: 705–709
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Dedicated to H. G. Lasch in commemoration of his 60th birthday
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Janzarik, H., Remy, S., Morell, S. et al. “Haemostasis time”, a modified bleeding time test and its comparison with the duke and IVY/template bleeding times. Blut 52, 345–356 (1986). https://doi.org/10.1007/BF00320781
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DOI: https://doi.org/10.1007/BF00320781