Utilization of thromboelastograms in management of <i>Crotalus adamanteus</i> envenomation

Rushton, William F.; Rivera, Jessica V.; Brown, Julie; Kurz, Michael C.; Arnold, Justin K.

doi:10.1080/15563650.2020.1788053

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…The α-angle displayed a low sensitivity compared with K, MA, and G at the lowest concentration. However, a previous report on pit viper envenomation used TEG to guide additional anti-venom treatment and identified the α-angle as a particularly useful parameter [41]. The α-angle increased several hours before the measurable fibrinogen level in a patient with hypofibrinogenemia [41].…”

Section: Discussionmentioning

confidence: 99%

“…However, a previous report on pit viper envenomation used TEG to guide additional anti-venom treatment and identified the α-angle as a particularly useful parameter [41]. The α-angle increased several hours before the measurable fibrinogen level in a patient with hypofibrinogenemia [41]. As such, the α-angle is a more valuable parameter for patients with hypofibrinogenemia, where several boluses of anti-venom have already been administered, and a decision about administering additional anti-venom needs to be made.…”

Section: Discussionmentioning

confidence: 99%

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Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Lee

Kim

2022

Animals

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Snake envenomation may lead to venom-induced consumptive coagulopathy (VICC), usually diagnosed by classical coagulation tests (CCTs), such as prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, the results of CCTs are frequently normal in the initial stages, which may delay anti-venom treatments. Thromboelastography (TEG) is a point-of-care and real-time diagnostic tool that enables a comprehensive assessment of the coagulation process. This in vitro study aimed to determine concentration-dependent changes in canine blood caused by Gloydius ussuriensis (G. ussuriensis) envenomation using TEG and CCTs. Lyophilized G. ussuriensis venom was reconstructed using mouse intravenous lethal dose 50 (LD50iv) and serially diluted to 25% LD50iv, 50% LD50iv, and 75% LD50iv to reproduce VICC at different concentrations. Normal saline was used for the control. We compared TEG values of the reaction time (R), kinetic time (K), rate of clot formation (α-angle), maximum amplitude (MA), fibrinolysis at 30 min (LY30), and global strength of the clot (G) with those of PT, aPTT, fibrinogen, and platelet counts (PLTs). Most TEG parameters, except R and LY30, demonstrated statistically significant changes compared with the control at all concentrations. CCTs, except PLTs, revealed significant changes at ≥50% LD50iv. Thus, TEG could be a useful diagnostic strategy for early VICC and preventing treatment delay.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Lee

Kim

2022

Animals

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“…3 Another case study demonstrated TEG's ability to detect improvements in clotting function before standard coagulation studies reported the functioning improvements. 4 It is essential to expand the use of TEG in evaluating and managing snake bite patient care with continued research into the topic. More widespread retrospective studies are warranted to develop larger patient pools who have used TEG in these situations.…”

mentioning

confidence: 99%

Use of Thromboelastography in Assessment of Snake Bite Coagulopathy

Hammond,

Ninad,

Christie

2024

The American Surgeon™

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Background: Monitoring for envenomation coagulopathy following snake bites has traditionally involved using serial coagulation studies. Purpose: Thromboelastography (TEG), with its real-time assessment, could offer an alternative to standard of care. This study aims to evaluate the use of TEG with traditional coagulation labs in the assessment of snake bite coagulopathy. Research Design: A retrospective review of patients who presented to a level 1 trauma center between 2014 and 2020 with snake bite envenomation was conducted, comparing traditional coagulation studies to TEG plus coagulation studies. Results: The 12 patients who had studies within the stipulations of our review were tracked and subsequently progressed well clinically with no adverse effects and ultimately discharged home with an average hospital stay of 2.2 days. Conclusions: Our data suggests that patients can be observed clinically without needing repeat coagulation studies if initial TEG and TCS are within normal limits.

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Coagulopathy induced by viperid snake venoms in a murine model: Comparison of standard coagulation tests and rotational thromboelastometry

Rucavado

Chacón

Villalobos

et al. 2022

Toxicon

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Utilization of thromboelastograms in management of Crotalus adamanteus envenomation

Cited by 3 publications

References 13 publications

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Hemostatic Analysis of Simulated Gloydius ussuriensis Envenomation Using Canine Blood: A Comparison of Thromboelastography and Classical Coagulation Tests

Use of Thromboelastography in Assessment of Snake Bite Coagulopathy

Coagulopathy induced by viperid snake venoms in a murine model: Comparison of standard coagulation tests and rotational thromboelastometry

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