The Effects of Antithrombin III on Disseminated Intravascular Coagulation(DIC) in Premature Infants

Sepsis and its associated complication of disseminated intravascular coagulation (DIC) are considered to be a major cause of morbidity and mortality in the newborn infants. Antithrombin(AT) is a single chain glycoprotein in plasma and belongs to the family of the serpins. It is an important anticoagulant protein acting as a heparin cofactor. However, it's effects and action in preterm infants are not clearly defined. The objective of this study was to determine whether AT III was effective in treatment of DIC in the premature infants.

We studied 52 preterm infants with clinical and laboratory diagnosis of DIC from November 1998 to October 1999. We examined the AT III, platelet, prothrombin time(PT), activated partial thromboplastin time(aPTT), fibrinogen, fibrinogen degradation product(FDP), and D-dimer before and after the treatment with AT III.

1) AT III concentrates were administerd for a mean of 3.6 days. Plasma AT III concetrations were elevated significantly(p<0.001) in all cases to a mean level of 134.5%.

2) Hematologic data(PT, aPTT, Fibrinogen, FDP) was significantly improved in definitive DIC group after AT III treatment(p<0.05).

3) The incidence of complications of DIC patients were slightly higher in definitive DIC group than in suspected DIC group, but there was no statistically significant difference. And AT III concentrate were well tolerated in all patients.

This data suggested that AT III therapy was effective to improve the clinical and laboratory findings without significant side effects in the premature infants with DIC.