Anticoagulant therapy in neonatal acute infectious peritonitis based on the TAT, PIC, tPAIC, and sTM: a new case series

Abstract Background: Neonatal acute peritonitis is a leading cause of morbidity and mortality and poses challenges that demand prompt diagnosis and treatment, particularly in infants with disseminated intravascular coagulation. Case presentation：Here, we report a case series of four infants with acute perionitis caused by necrotising enterocolitis, gastrointestinal perforation, and meconium peritonitis. Laboratory tests for thrombin-antithrombin complex(TAT), α2-plasmin inhibitor-plasmin complex(PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator-inhibitor complex (tPAIC) suggested the activation of the coagulation system followed by treatment with anticoagulant therapy in these infants. Conclusions: Overall, thrombin-antithrombin complex, α2-plasmin inhibitor-plasmin complex, soluble thrombomodulin, and tissue plasminogen activator-inhibitor complex may guide anticoagulant therapy, offering prospects for improving the outcomes in neonates with acute peritonitis.