Experience with disseminated intravascular coagulation in a children's hospital.

A study was initiated to determine the frequency and significance of disseminated intravascular coagulation (DIC) in the pediatric age group. With the aid of a scoring system, DIC was diagnosed in 48 patients in a period of slightly over one year in a pediatric referral centre with 7000 annual admissions. Sixty percent of all DIC occurred in infants under one month of life. Sixty-six percent of all DIC was associated with sepsis, usually from gram-negative infections. Seventy-nine percent of affected neonates were septic. Laboratory findings of diagnostic importance were anemia with red cell fragmentation, thrombocytopenia, elevated titres of fibrin split products, abnormal thrombin time, and low factor V activity. Mortality was 64% in all ages regardless of cause. Results of management of DIC by treatment of the underlying disease with or without anticoagulation were disappointing.