Snake antivenom for snake venom induced consumption coagulopathy

Maduwage, Kalana; Buckley, Nicholas A.; Silva, H Janaka de; Lalloo, David G.

doi:10.1002/14651858.cd011428

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…5 There are no randomized controlled trials studying the efficacy of ASV in the treatment of VICC in comparison to a placebo or observation without intervention. 18 Anti-snake venom is still the recommended choice of treatment in VICC, 4 and it can be beneficial for other potential lethal signs of snakebite envenoming such as AKI and neurological complications. 1 In our study, five patients in 2015 still developed renal dysfunction after the administration of one dosage of ASV due to VICC.…”

Section: Resultsmentioning

confidence: 99%

Snakebites in Suriname: Evaluation of the Protocolled Administration of Anti-Snake Venom in a Tertiary Care Setting

Ramdhani

Jonker

Kruys

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Venomous snakebites regularly occur in Suriname, a middle-income country located on the north coast of South America. Officially reported data on incidence and mortality are lacking. The aim of this retrospective study was to assess whether the use of our national snakebite protocol with selective administration of anti-snake venom (ASV) in patients with signs of snakebite envenoming improved clinical outcome as measured by mortality and length of stay (LOS) in the hospital. Medical records of all patients admitted at the Academic Hospital Paramaribo from 2013 to 2015, before and after the introduction of the protocol, with signs of snakebite envenoming, were reviewed for demographics, snakebite characteristics, mortality, length of hospital stay, administration of ASV, and occurrence of complications. Secondary outcome measures were the development of late complications due to a snakebite. Sixty-eight and 76 patients in 2013 and 2015, respectively, with venomous or potentially venomous snakebites were identified. One patient (1.5%) in 2013 and 29 patients (38.2%) in 2015 received ASV. In 2013 one patient died: deterioration of renal function occurred before protocolled ASV administration. No deaths were reported in 2015. There was no difference in the overall length of hospital stay between 2013 and 2015 or in the total number of late complications. In 2015, the mean LOS (±SD) for patients who did not receive ASV (n = 47) was significantly lower than that for patients who received ASV (n = 29), 2.15 ± 2.27 versus 5.31 ± 5.53 days, respectively (P = 0.001). The mean LOS (±SD) for patients who did not receive ASV in 2013 (n = 67) and 2015 (n = 47) was 4.06 ± 5.44 and 2.15 ± 2.27 days, respectively, which also differed significantly (P = 0.025). The protocolled evaluation of snakebite victims resulted in more patients being admitted to the intensive care unit and receiving ASV and a shorter length of hospital stay for the patients who did not receive ASV, and no difference in the occurrence of complications was observed in Suriname's largest hospital responsible for the acute care of snakebite victims.

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Section: Resultsmentioning

confidence: 99%

Snakebites in Suriname: Evaluation of the Protocolled Administration of Anti-Snake Venom in a Tertiary Care Setting

Ramdhani

Jonker

Kruys

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…Local tissue destruction occurs to varying degrees in nearly all victims and generally presents with swelling and erythema [1,4]. Systemic effects of pit-viper envenomation include anaphylaxis, shock, coagulopathy, and less commonly, respiratory failure [5][6][7]. Intubation is exceedingly rare as a direct result of rattlesnake envenomation [7].…”

Section: Introductionmentioning

confidence: 99%

Rattlesnake Envenomation in a Venom-Naive Man With Significant Coagulopathy and Severe Oropharyngeal Edema Requiring Emergent Surgical Airway

et al. 2021

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The majority of snakebite envenomation events in North America are attributed to rattlesnakes with pit-vipers responsible for nearly all envenomation events. Significant morbidity is associated with rattlesnake envenomation including local tissue destruction and coagulopathy. Severe oropharyngeal edema requiring emergent securing of airway has been reported in victims with no prior exposure to pit-vipers but is exceptionally rare. We present a case report of a venom-naive male in his early twenties who received a pit-viper bite to the right thumb, resulting in an anaphylactoid reaction complicated by severe oropharyngeal edema, coagulopathy, and persistent respiratory failure requiring prolonged ventilator support. This case highlights how anaphylactic and anaphylactoid reactions are nearly identical in presentation and may be associated with significant morbidity. Regardless of whether the underlying etiology is anaphylaxis or anaphylactoid, the management should focus on providing CroFab ® early in the clinical course.

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