The use of antivenom serum, fresh frozen plasma, and platelet concentrate for management strategy of snakebite related coagulopathy: a case series | [Anaesthesia, Pain and Intensive Care • 2023]

Author(s):

1. Septian Adi Permana: Department of Anesthesia and Intensive Therapy, UNS Faculty of Medicine, Dr. Moewardi Hospital,E-mail,Indonesia.

2. Muhammad Markam Shalihin: Department of Anesthesia and Intensive Therapy, UNS Faculty of Medicine, Dr. Moewardi Hospital,Surakarta, Central Java,Indonesia.

Abstract:

Snakebite is a medical emergency. It can cause local and systemic effects in humans. Different venomous snakes produce different types of venom, which can cause a variety of symptoms and complications. The scarcity of antisnake venom serum (SABU) in Indonesia encourages alternative administration strategies to patients, namely suboptimal doses or subdose. Three cases of adult patients with a history of snakebite and diagnosed with snakebite grade III were reported. The patient underwent initial antivenom therapy using suboptimal doses of anti-snake venom serum (SABU) due to the scarcity of SABU and fresh frozen plasma (FFP) and thrombocyte concentrate (TC) transfusions as well as initial emergency management and routine blood tests and coagulation function. Evaluation was done daily of clinical improvement and coagulation function. This case series proves that administration of suboptimal antivenom therapy, when combined with additional FFP and TC transfusions, coupled with appropriate supportive care and patient monitoring can result in good outcome in patients.

Page(s): 750-756

DOI: 10.35975/apic.v27i6.2250

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 27, Issue: 6, Year: 2023

Keywords:

Snakebite , toxin , Antisnake Venom Serum , Thrombocyte Concentrate , FFP

References:

[1] .2019 .Fact sheet of Snakebite envenoming. , : .

[2] .2016 .Management of snakebites. , : .

[3] Panggabean M,Solihat Y.,Post-General Anesthesia Angioedema after General Anesthesia. Solo J Anesth Pain Crit Care Y. .2022 .. DOI: 10.20961/soja.v2i1.59185, 2(1) : .

[4] Al Masroori S,Al Balushi F .2022 .Al Abri S. Evaluation of Risk Factors of Snake Envenomation and Associated Complications Presenting to Two Emergency Departments in Oman. Oman Med J. 2022 Mar, 22(2) : e349.

[5] Costello RA,Nehring SM . .. Disseminated Intravascular Coagulation. [Updated 2023 Jan, 20 : .

[6] Island (FL): StatPearls Publishing Treasure,Liang Q,Liang Z,Han J,Wu M,Liu R .2023 .. , : .

[7] . .Effectiveness of clotting factor replacement therapy after antivenom treatment on coagulopathic envenomation following green pit viper bites: a retrospective observational study. 2022 Jan, 19(1) : 9.

[8] .2013 .. , 10(3) : 60-83.

[9] Hofer S,Schlimp CJ,Casu S,Grouzi E.,Isbister GK,Buckley NA,Page CB,Scorgie FE,Lincz LF,Seldon M .2013 .A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18). J Thromb Haemost, 11(7) : 1310-8.

[10] Maduwage K,Isbister GK . .Current treatment for venom-induced consumption coagulopathy resulting from snakebite. 2014 Oct, 23(10) : .

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