Development and Practical Use of the New Quantitative Bleeding Time Test Apparatus

Summary

We have developed a new computerized system for measurement of quantitative bleeding time (QBT) to detect subtle abnormalities of primary hemostasis that are difficult to detect with the standard bleeding time determination. This new apparatus can simultaneously measure the bleeding time (BT; sec), amount of total blood loss (Tv; μl), maximum bleeding rate (Rmax; μl/sec) and bleeding pattern from the bleeding time incision. We have also developed a new holder for the Simplate that enables more consistent incisions and thus improves the reproducibility of the BT test.

In this study, the newly developed QBT test was performed in 137 normal healthy volunteers and 10 patients having defined abnormalities of either primary or secondary hemostasis. Comparisons of the standard BT test and our QBT were made in 5 normal subjects and 7 thrombocytopenic patients. Additionally, 6 normal subjects were examined with both tests before and after administration of aspirin. Those results show that our QBT appears to be a more sensitive indicator of primary hemostasis than the standard BT method.

• References

• 1 Day HJ, Rao AK. Evaluation of platelet function. Semin Hematol 1986; 23: 89-101.
• 2 Adelson E, Crosby WH. A new method to measure bleeding time: the “immersion” method. Acta Haematol (Basel) 1975; 18: 281-9.
• 3 Willoughby MLN, Allington MJ. The rate of blood loss from skin punctures during the Ivy bleeding time test. J Clin Pathol 1961; 14: 381-4.
• 4 De Nicola P. Critical evaluation of methods for the study of blood coagulation, fibrinolysis and hemostasis. Thromb Diath Haemorrh 1962; 7 (Suppl. 01) 325-33.
• 5 Sutor AH, Bowie EJW, Thompson Jr. JH, Didisheim P, Mertens BF, Owen Jr. CA. Bleeding from standardized skin punctures: automated technique for recording time, intensity, and pattern of bleeding. Am J Clin Path 1971; 55: 541-50.
• 6 Sutor AH, Bowie EJW, Owen Jr. CA. A new method of demonstrating the effect of therapy in von Willebrand’s disease. Mayo Clin Proc 1971; 46: 345-6.
• 7 Bowie EJW, Owen Jr. CA, Hansen RJ, Isaacson J. Electronic method for quantitation of bleeding time. Am J Clin Path 1972; 58: 255-9.
• 8 Milian MG. Technique pour l’étude clinique de la coagulation du sang. Soc Med Hop 1901; 18: 777-83.
• 9 Duke WW. The relation of blood platelets to hemorrhagic disease: description of a method for determining the bleeding time and coagulation time and report of three cases of hemorrhagic disease relieved by transfusion. JAMA 1910; 55: 1185-92.
• 10 Ivy AC, Shapiro PF, Melnick P. The bleeding tendency in jaundice. Surg Gynecol Obstet 1935; 60: 781-4.
• 11 Mielke Jr. CH, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SI. The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 34: 204-15.
• 12 Lind SE. The bleeding time does not predict surgical bleeding. Blood 1991; 77: 2547-52.
• 13 O’Laughlin JC, Hohtiezer JW, Mahoney JP, Ivey KJ. Does aspirin prolong bleeding from gastric biopsies in man?. Gastrointest Endosc 1981; 27: 1-5.
• 14 Rodgers C, Levin J. A critical reappraisal of bleeding time. Semin Thromb Hemost 1990; 16: 1-20.