New Bleeding Time Devices with Retractable Blades Evaluated in Children, Healthy Volunteers and Patients with Prolonged Bleeding Time

Summary OBJECTIVE Hypothyroidism can be complicated by bleeding symptoms such as easy bruising, menorrhagla and sometimes even a severe bleeding tendency with fatal outcome. Usually there is a prolonged bleeding time, or a low plasma concentration of coagulation factor VIII (FVIII) or von Willebrand factor (vWF). The aim of the present study was to investigate the acute haemostatic effect of desmopressin in hypothyroid patients. Another aim was to study the long‐term effect of thyroxine replacement on the plasma concentrations of coagulation factors and to ascertain the duration of thyroxine treatment needed to restore haemostatic function. DESIGN AND PATIENTS The effects of desmopressin, given intravenously over 10 minutes at a dosage of 0.3 μg/kg, and thyroxine treatment on haemostatic function were studied prospectively In 10 patients with hypothyroidism. RESULTS Before treatment only five of the patients manifested bleeding symptoms; one had prolonged bleeding time, and one had low plasma concentrations of vWF: Ag. Desmopressin virtually immediately reduced bleeding time, enhanced platelet adhesiveness, and significantly increased plasma concentrations of FVIII and vWF. The plasma concentrations of FVIII and vWF showed a significant increase after 4 months, whereas 7 months treatment with thyroxine was needed to reduce bleeding time significantly. CONCLUSION Our results suggest that in hypothyroid patients desmopressin may be of value for the acute treatment of bleeding or as cover for surgery.

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“…Bleeding time was measured with a Simplate-I1 device (normal range 220-650 s) (Lethagen & Kling, 1993).…”

Section: Haemostatic Variablesmentioning

confidence: 99%

Effect of acute desmopressin and of long‐term thyroxine replacement on haemostasis in hypothyroidism

Erfurth

Ericsson

Egervall

et al. 1995

Clinical Endocrinology

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“…There is an apparent contrast between results from conventional platelet aggregation assays that suggest an in vitro hypofunctional state of neonatal platelets [1][2][3] and the evidence of normal or even short in vivo bleeding times of the newborn [4] , which is a suitable test for assessing primary hemostasis [5] .…”

Section: Introductionmentioning

confidence: 99%

Collagen/Endogenous Thrombin-Induced Platelet Aggregation in Cord versus Adult Whole Blood

Cvirn¹,

Kutschera

Wagner

et al. 2008

Neonatology

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Background: In previous studies, neonatal platelets have been shown to be hypoaggregable to various agonists when compared with adult platelets. Objectives: It was the aim of this study to investigate the aggregability of neonatal versus adult platelets when the physiological relevant agonist collagen/endogenous thrombin is used. Methods and Results: Whole blood (WB) aggregation experiments employing the impedance method revealed the same responsiveness of neonatal and adult platelets to collagen/endogenous thrombin. Maximum aggregation (13.5 ± 3.2 vs. 13.6 ± 3.2 Ω; p = 0.94), slope (5.8 ± 1.8 vs. 6.2 ± 2.6 Ω/min; p = 0.79) and lag time until the onset of platelet aggregation (38.7 ± 8.9 vs. 42.6 ± 16.5 s; p = 0.59) were similar in cord and adult WB. However, the rise in serotonin plasma levels due to platelet activation was significantly lower in neonates versus adults (227.57 ± 57.65 vs. 473.34 ± 155.75 ng/ml; p = 0.0001). Furthermore, we found a fast capability of cord plasma to generate (the efficient platelet agonist) endogenous thrombin: thrombin generation started significantly earlier in cord compared with adult plasma (215 ± 19 vs. 247 ± 21 s; p = 0.01). Moreover, thrombelastometry revealed significantly shorter coagulation times in cord versus adult WB activated with collagen/endogenous thrombin (229.8 ± 12.5 vs. 256.3 ± 25.3 s; p = 0.003). Conclusions: The efficient platelet aggregation in cord WB provoked by collagen/endogenous thrombin might help to explain the clinically observed well-functioning primary hemostasis of neonates.

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“…Bleeding time was measured by the Simplate II ® method (see below) 2, 4, and 8 hours following the 0700 dose on Days 1 and 8 and also 30 minutes predose on Day 8. 39 On the last day of treatment, a physical examination, including weight and vital signs, was performed. Within 24 hours following the final dose of study medication, blood was drawn for the final clinical laboratory tests.…”

Section: Treatment Periodmentioning

confidence: 99%

“…Bleeding time was measured according to the Simplate II ® method. 39 A sphygmomanometer cuff was placed on the subject's upper arm and inflated to 40 mmHg. A disposable template was placed on the forearm distal to the antecubital fossa over an area without any superficial veins.…”

Section: Bleeding Timementioning

confidence: 99%

The COX‐2 Selective Inhibitor, Valdecoxib, Does Not Impair Platelet Function in the Elderly: Results of a Randomized Controlled Trial

Leese

Recker²,

Kent³

2003

The Journal of Clinical Pharma

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The effects of the new cyclooxygenase (COX)-2 selective inhibitor, valdecoxib (40 mg bid; n = 17), on platelet function were evaluated, along with ibuprofen (800 mg tid; n = 15) and placebo (n = 15), in healthy elderly subjects (65-85 years) in this 7.5-day, randomized, single-center, double-blind study. Platelet aggregation (to sodium arachidonate, collagen, and adenosine diphosphate), bleeding time, and serum thromboxane B2 (TxB2) concentrations were measured up to 8 hours postdose on Days 1 and 8. Valdecoxib had no platelet effects, while ibuprofen significantly decreased platelet aggregation, significantly increased bleeding time (2-4 h postdose on each day), and significantly decreased TxB2 levels at all time points. In conclusion, unlike ibuprofen, valdecoxib 40 mg bid spares platelet COX-1 function in healthy elderly subjects. Valdecoxib's lack of effect on platelet aggregation and bleeding time suggests that it will have an improved clinical profile over nonselective NSAIDs, particularly in patients for whom bleeding complications are a concern.

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New Bleeding Time Devices with Retractable Blades Evaluated in Children, Healthy Volunteers and Patients with Prolonged Bleeding Time

Cited by 18 publications

References 4 publications

Effect of acute desmopressin and of long‐term thyroxine replacement on haemostasis in hypothyroidism

Effect of acute desmopressin and of long‐term thyroxine replacement on haemostasis in hypothyroidism

Collagen/Endogenous Thrombin-Induced Platelet Aggregation in Cord versus Adult Whole Blood

The COX‐2 Selective Inhibitor, Valdecoxib, Does Not Impair Platelet Function in the Elderly: Results of a Randomized Controlled Trial

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