Disseminated intravascular coagulation (DIC) and hyaline membrane disease (HMD)

Abstract

A prospective study was planned to determine whether or not DIC contributes to the pathogenesis of HND and to ascertain the possible role of DIC in the production of the intra-cranial hemorrhages (ICH) frequency found at autopsy in HMD. In order to deterct DIC, platelet counts, fibrinogen, factors V and VIII levels, ethanol gelation tests and tanned red cell hemoagglutination inhibition immuno-assays were performed on the first or second day of life in 11 premature infants with the typical clinical and radiological findings of severe HMD. In 5 infants the tests were repeated on one or more occasions during the first 10 days of life. 16 normal premature infants of similar gestational and postnatal ages were also studied and served as controls; none of these infants had evidence of DIC and they all survived. Conclusive evidence of DIC was found only in 2 infants with HMD: one had DIC on day 1 and died; the other developed DIC on day 8 while on the respirator and survived. Four of the remaining 9 infants with HMD died; autopsy was performed in 3 and showed extensive HMD in all and severe ICH in 2. These data, although preliminary, suggest that DIC does not play a major role in the pathogenesis of HMD and that its is not an important contributing factor in the high mortality and frequent ICH in babies with HMD.