Coagulation changes in the newborn with respiratory failure

Abstract

These studies involved clinical and laboratory investigations in 24 infants. Eleven healthy premature and term babies were used to establish a normal laboratory range. Thirteen consecutive infants requiring ventilatory assistance were compared to the normal group according to a broad range of clinical and laboratory measurements. Clinical parameters of the two groups were obviously different. However, the laboratory measurements of clotting appears to be close in each group only within the first 12 hours of extrauterine life. The fibrinolytic system appeared to be the most significantly activated parameter as seen by the initial deviations of the plasminogen and fibrin split products in the ill infants. Related changes in complement C′3 and C′4 were also noted. Two of the study infants survived and their data is shown for prognostic purposes. The earliest results that appeared to discriminate between survivors and fatalities were the plasminogen levels at 12 to 24 hours. We conclude from these data that activation of coagulation, fibrinolytic, and complement systems occurs in all newborns with respiratory failure and is detectable in their laboratory measurements.