Thigh bleeding time as a valid indicator of hemostatic competency during surgical treatment of patients with advanced renal disease.
We compared the usefulness of the modified Ivy bleeding time performed in the forearm (arm bleeding time) with that performed in the thigh (thigh bleeding time) as an indicator of hemostatic competence during surgical treatment in 16 patients with chronic renal failure. In 22 normal adults, the arm bleeding time (mean plus or minus standard deviation, 6.6 +/- 1.4 minutes) was significantly longer than the value in the thigh (mean plus or minus standard deviation, 4.1 +/- 1.3 minutes) (p less than 0.001), and there was no correlation between arm and thigh bleeding time. Preoperatively, the arm bleeding time in patients with renal disease was markedly prolonged (greater than 20 minutes) in 15 patients and slightly prolonged in one patient. There was no abnormal perioperative bleeding in 13 patients whose preoperative thigh bleeding time was seven minutes or less. Prolonged and excessive perioperative bleeding was observed in three patients whose thigh bleeding time was 8.0, 9.5 and 26.5 minutes. These findings suggest that thigh bleeding time is a better indicator of competence of primary hemostasis during the operation than the arm bleeding time in patients with advanced renal failure.
Liu
Y K
YK
Louisville Hematology Clinic, Kentucky 40202.
Goldstein
D M
DM
Arora
K
K
Woo
D
D
Ferris
F Z
FZ
Marcum
S G
SG
Garrison
R N
RN
Amin
M
M
D000328:Adult; D000368:Aged; D001132:Arm; D001760:Bleeding Time; D005260:Female; D006487:Hemostasis; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012016:Reference Values; D013514:Surgical Procedures, Operative; D013848:Thigh; D014511:Uremia / Q000503:physiopathology*