Skip to main content

Table 1 Summary of selected therapeutic approaches using replacement of specific anticoagulation and fibrinolytic proteins to treat DIC. This table is based on a PubMed search using the key words: "Disseminated Intravascular Coagulation", "Therapy for DIC", "Animal experimentation on DIC" and "Neonate or Newborn." A representative selection was chosen from a total of 98 papers in the period 1970 to 2005 to give an overview of the literature on this subject.

From: Antithrombin III (AT) and recombinant tissue plasminogen activator (R-TPA) used singly and in combination versus supportive care for treatment of endotoxin-induced disseminated intravascular coagulation (DIC) in the neonatal pig

Subject

Mortality Rate

N

Therapeutic Factor

Provoking Factor

Outcome

Reference

Coagulation Pathway

Children

not addressed

4

Protein C

meningococcemia

reversed organ dysfunction

[16]

Infants, adolescents

25%

8

Protein C

meningococcemia

restored micro-circulation

[17]

Children 1 mo-5 yr

17%

6

AT

sepsis, carcinoma, Reye's

normalized coagulation studies

[18]

Newborns

40%

10

AT, heparin

sepsis

improved coagulation

[22]

Child

100%

1

AT, Protein C

Unknown, ARDS

stopped bleeding

[19]

Baboons

67–100%

3

Protein C

E. coli organisms

prevented coagulopathy, lethal effects

[25]

Adult pigs

not addressed

16

AT

E. coli endotoxin

Improved MAP, SVR

[23]

Guinea pigs

0% with Tx

58

Antithrombin Concentrate & LMWH

S. aureus isolates

Decreased fibrin deposits, improved survival

[26]

Adult pigs

Not addressed

 

AT

LPS

decreased DIC, improved survival

[21]

Adult pigs

Not addressed

21

AT

LPS

reduced effusion, edema

[27]

Newborn and 3 wk old piglets

Not Addressed

>>16/age group & dose

Heparin

125I-Fibrinogen

↑ AT conc. Improved the antithrombotic effects of heparin

[28]

Fibrinolytic Pathway

Infant, 4 mo

0%

N 1

R-TPA

meningococcemia

improved organ perfusion, cardiac performance

[24]

Infants

0%

2

R-TPA

Meningococcemia

Improved micro-circulation

[20]

Combined Coagulation and Fibrinolytic Pathways

Adult rabbits

70 → 40% R-TPA alone, 70 → 0% both factors

N

R-TPA, R-hirudin

endotoxin

Improved hemostatic markers, decreased fibrin deposits

[11]

  1. Legend: ARDS Adult respiratory distress syndrome
  2. E. Coli Escherichia Coli
  3. kg kilogram
  4. LMWH Low molecular weight heparin
  5. MAP Mean Arterial Pressure
  6. SVR Systemic Vascular Resistance
  7. S. aureus Staphylococcal aureus
  8. Tx Therapy
  9. R-hirudin Recombinant Hirudin
  10. N Subject number