# Anticoagulant Therapy in Neonatal Acute Infectious Peritonitis Based on the TAT, PIC, t-PAIC, and sTM: A New Case Series

## TL;DR

This case series explores anticoagulant therapy in neonates with acute peritonitis using specific coagulation markers to improve outcomes.

## Contribution

The study introduces a new approach using TAT, PIC, t-PAIC, and sTM to guide anticoagulant therapy in neonatal peritonitis.

## Key findings

- Four infants with acute peritonitis showed coagulation system activation based on TAT, PIC, t-PAIC, and sTM levels.
- Anticoagulant therapy was administered following these laboratory findings.
- The markers may help guide treatment and improve outcomes in neonates with acute peritonitis.

## Abstract

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. Here, we report a case series of four infants with acute peritonitis caused by necrotizing enterocolitis, gastrointestinal perforation, and meconium peritonitis. Laboratory tests for thrombin–antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), soluble thrombomodulin (sTM), and tissue plasminogen activator–inhibitor complex (t-PAIC) suggested the activation of the coagulation system followed by treatment with anticoagulant therapy in these infants. Overall, TAT, PIC, t-PAIC, and sTM may guide anticoagulant therapy, offering prospects for improving the outcomes in neonates with acute peritonitis.