Coagulation function changes and the clinical implication in children with systemic inflammatory response syndrome

Abstract

Objective To study the coagulation disorder in children with systemic inflammatory response syndrome (SIRS) and their influences on the prognosis. Methods A prospective case-control study was carried out in our ICU. According to the pediatric/neonatal new definition of SIRS, all the patients were divided into 2 groups:SIRS group (24 cases) and non-SIRS group (21 casea), as well as 28 control cases were included. The SIRS group was divided into 2 subgroups:death and survivor subgroup. Levels of platelet (PLT), prothrombin test (PT), activated partial thromboplastin time ( APTT ), fibrinogen (FBG), thrombin antithrombin complex (TAT), antithrombin Ⅲ (AT-Ⅲ), protein C (PC), thrombomodulin (TM), tissue-type plsminogen activator (TPA), D-dimer (DD) were measured in all cases. Results ( 1 ) Levels of PT, APTT, TAT, TM, DD, TPA were significantly higher in SIRS group than those in non-SIRS group and control group ( P 0.05 ). (2) The coagulation indexes of death cases were not significantly different from those of survivors(P > 0.05). Conclusion (1) Patients with SIRS have coagulation disorder, characterized by coagulation activation, anticoagulation consumption and fibrinolysis activation. (2) Molecular markers of blood coagulation are good markers to reflect the different stages of early SIRS. (3) Impact of blood coagulation markers on the patients' prognosis needs to be further evaluated by enlarging the sample size. Key words: Systemic inflammatory response syndrome; Coagulation disorder dysfunction; Molecular markers of blood coagulation; Multiple organ failure