The relationship between hematocrit and bleeding time in very low birth weight infants during the first week of life

Objectives: The bleeding time is a measurement of platelet and capillary interaction following a small standardized cutaneous incision. In adults, anemia causes a prolongation of the bleeding time, and we hypothesized that the same would be true in very low birth weight (VLBW) infants during their first week of life. Study Design: Template bleeding times, using the Surgicutt Newborn device, were performed on 20 VLBW weight infants ≤7 days old, before, and again following a clinically ordered erythrocyte transfusion. Results: Neonates who had pretransfusion hematocrits ≤0.28 l/l had longer bleeding times, which fell 164±25 seconds (mean ± SD; p < 0.0001) following transfusion. Patients with pretransfusion hematocrits > 0.28 l/l had no significant reduction in bleeding time following transfusion. Conclusions: In VLBW infants, during their first week of life (the time when their risk of intraventricular hemorrhage is greatest), a low hematocrit is associated with a significant prolongation in the bleeding time.