[New approach to the diagnosis of disseminated intravascular coagulation in childhood].

The peak incidence of DIC in the pediatric age group is in the neonatal period. The newborn infant is particularly susceptible to DIC because of several handicaps, such as physiological hypofunction of anticoagulant and fibrinolytic systems, an underdeveloped capacity in the reticuloendothelial system and a tendency to develop acidosis, hypothermia, hypoxia and shock. Although some criteria have been reported for the diagnosis of DIC in adults, based on clinical and laboratory findings, these are not necessarily applicable to the diagnosis of DIC in newborn infants. This is because a large blood sample is required, a long period of time is necessary for assay and difference in several coagulation and fibrinolysis factors exist between newborn infants and adults. We therefore established a criteria for the diagnosis of DIC in newborn infants, based on data obtained from newborn infants with DIC. Diagnostic procedures of many molecular markers of hemostasis have been developed from this. Some of them, such as FDP-D dimer are valuable for the diagnosis in children but others are not necessarily useful because of the susceptibility to the venipuncture technique. Our criteria for the diagnosis of DIC in newborn infants must be modified in the diagnosis of DIC in very low birth weight infants.