Diagnosis of DIC in very low birth weight infants

Disseminated intravascular coagulation (DIC) occurs most frequently during the neonatal period. We have already established criteria for the early diagnosis of DIC in newborn infants, based on the analysis of clinical and laboratory findings in neonates with and without DIC. In that study, laboratory findings for subjects without DIC were evaluated based on the results obtained from neonates whose birth weights were more than 1500 g. Accordingly, these criteria are not necessarily applicable to the diagnosis of DIC in very low birth weight infants (VLBWI) since the physiological and pathological states of coagulation and fibrinolysis in VLBWI may differ from those of term newborn infants. Therefore, we measured platelet counts, plasma fibrinogen contents and the fibrin degradation product (D-dimer) concentrations in VLBWI with and without DIC. These findings indicate that the scoring system for platelet counts in our diagnostic criteria of DIC in newborn infants is applicable to the diagnosis of DIC in VLBWI. However, our scoring systems for fibrinogen and D-dimer were not usable for the diagnostic criteria of DIC in VLBWI since fibrinogen and D-dimer concentrations in VLBWI without DIC were lower than those in non-DIC neonates whose birth weights were above 1500 g. We devised criteria for the diagnosis of DIC in VLBWI based on those findings.