Evaluation of hypercoagulability using soluble fibrin monomer complex in sick newborns.

BACKGROUND

Soluble fibrin monomer complex (SFMC) and fibrin monomer (FM) are well known as markers for hypercoagulability, but such measurements have not been investigated in detail for the neonate. To identify the presence of a hypercoagulable state in sick newborns, the behavior of SFMC with special reference to those of other coagulation tests, and the relationships with other parameters of blood coagulation as well as lactate, which is considered to be the gold standard for assessing tissue hypoxia, were studied.

METHODS

Records of 216 sick newborns, who had undergone blood coagulation tests, were retrospectively studied based on their medical records.

RESULTS

SFMC had a significant correlation with d-dimer in infants with birthweight <1500 g, but no correlation was observed with prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, anti-thrombin or platelet count. In contrast, in infants with birthweight ≥ 1500 g, SFMC was correlated with PT, APTT, fibrinogen, and d-dimer, but no correlation was observed with anti-thrombin or platelet count. In addition, SFMC was significantly higher in the high lactate group (lactate ≥ 4 mmol/L), compared with the low lactate group (<4 mmol/L).

CONCLUSIONS

Measurement of blood SFMC is useful to monitor hypercoagulable state in sick newborns with hypoxia.