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 dia gnosis of DIG in newborn infants, based on the analysis of clinical and lab oratory findings in neonates with and without DIG, In that study, laborator y findings for subjects without DIC were evaluated based on the results obt ained from neonates whose birth weights were more than 1500 g, Accordingly, these criteria are not necessarily applicable to the diagnosis of DIC in v ery low birth weight infants (VLBWI) since the physiological and pathologic al states of coagulation and fibrinolysis in VLBWI may differ from those of term newborn infants. Therefore, we measured platelet counts, plasma fibri nogen contents and the fibrin degradation product (D-dimer) concentrations in VLBWI with and without DIG. These findings indicate that the scoring sys tem for platelet counts in our diagnostic criteria of DIC in newborn infant s is applicable to the diagnosis of DIC in VLBWI. However, our scoring syst ems for fibrinogen and D-dimer were not usable for the diagnostic criteria of DIC in VLBWI since fibrinogen and D-dimer concentrations in VLBWI withou t DIC were lower than those in non-DIG neonates whose birth weights were ab ove 1500 g, We devised criteria for the diagnosis of DIC in VLBWI based on those findings.