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[Epsylon-aminocaproic acid in the treatment of severe and dominating hyperfibrinolysis in a premature infant].

A premature infant of 31 weeks gestational age weighing 1650 g developed pronounced generalized bleeding following exchange transfusion for rhesus-incompatibility. As a consequence there was continuous leakage into a subcutaneous haematoma that had been caused by accidental puncture of the infant's flank during diagnostic amniocentesis. The ensuing massive and prolonged loss of blood required replacement by infusions of heparinized fresh blood over several days. The most conspicuous detail in the longitudinal study of haemostasis was hyperfibrinolysis with values for Fibrin-Fibrinogen Split Products exceeding 1280 micrograms/ml. This situation could be treated effectively with epsilon-amino-capronic acid. We suggest that anti-fibrinolytic agents can be recommended under cover of heparin for treating those rare cases in which hyperfibrinolysis predominates and clinical criteria of disseminated intravascular thrombosis are missing. We would, however, strongly discourage the uncritical use of antifibrinolytic agents whenever Fibrin-Fibrinogen-Split Products are detected.