The coagulation system in septic newborns.

Coagulation factors were examined in 48 newborns with spesis caused mainly by Klebsiella enterobacteriaceae and E. coli. The first examination revealed increased mean values of fibrinogen, antiplasmin, trypsin inhibitory capacity, factors II and X. Thrombocytes, plasminogen, antithrombin III, alpha 2-macroglobulin and factor V were reduced on average. Serial examinations brought to light turbulent dynamics of the parameters. In most cases the fibrinogen level increased first together with factors II, V and X, and with antiplasmin, and followed by antithrombin III and alpha 2-macroglobulin after several days. Trypsin inhibitory capacity decreases progressively, starting from extremely high levels or after an initial rapid increase. Thrombocytopenia is the last to correct. Close correlations between the fibrinogen level and factors II and X in the initial values, as well as in the course of the disease, point to the dynamics of these components being similar. These findings are reason to believe the pathogenetic importance of the disseminated intravascular coagulation in many cases. Rapid overproduction of components takes place after disseminated intravascular coagulation in sepsis; overproduction has its limits in production capacity and thrombocytopoiesis is the weakest link in newborns.