The preoperative bleeding time as a predictor of postoperative hemorrhage after cardiopulmonary bypass.

To determine whether the preoperative bleeding time, the most reliable indicator of in vivo platelet dysfunction, can prognosticate excessive postoperative hemorrhage and, hence, the need for infusion of platelet concentrations, we studied blood loss versus bleeding time in 43 patients undergoing coronary bypass grafting. There was no correlation between bleeding time and either fall in hemoglobin level (r = 0.04) or chest tube drainage (r = 0.004). In addition, bleeding time did not correlate with the number of units of platelet concentrate (r = 0.12) or packed red cells (r = 0.2) infused. The bleeding time, which has been recommended as an essential screening test before all cardiopulmonary bypass procedures, need not be performed as a preoperative screen in otherwise healthy patients with no history of bleeding abnormalities and a normal coagulation profile.