Rebound coagulopathy in patients with snakebite presenting with marked initial coagulopathy

Wilderness & Environmental Medicine
Willam R WithamSunny Patel

Abstract

An estimated 70% of patients with pit viper snakebites require antivenom to treat serious complications such as coagulopathy. Evidence-based guidance is limited for the appropriate administration of Crotalinae Polyvalent Immune Fab (FabAV) and the duration of laboratory follow-up. The objective of our study was to assess the incidence of marked and recurrent envenomation coagulopathy at our trauma center and identify practice patterns that may prevent serious complications. A retrospective case review was conducted over a 3-year period on patients treated for symptomatic snakebite injury. Case records were reviewed for the inclusion criteria of international normalized ratio (INR) greater than 2.0. The exclusion criterion was limited to patients receiving anticoagulant therapy. In all, 61 patients were identified on retrospective chart review and 3 patients (4.9%) met inclusion criteria. Two of the 3 patients had marked rebound coagulopathy requiring readmission and additional treatment. In our small series, 2 patients presenting after crotaline envenomation with increased INR (>6.0), decreased fibrinogen (<60 mg/dL), and decreased platelet count (<100,000/mL) had recurrent coagulopathy and were asymptomatic, and recurrence was...Continue Reading

References

May 8, 2003·Journal of Toxicology. Clinical Toxicology·Henry A Spiller, George M Bosse
Mar 3, 2007·Southern Medical Journal·David L MorganWilliam Tobleman
Jun 24, 2009·Intensive Care Medicine·Simon G A BrownGeoffrey K Isbister
Oct 19, 2010·Annals of Emergency Medicine·Eric J LavonasRichard C Dart
May 14, 2011·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Steven A SeifertNancy Martin
Mar 12, 2013·Toxicon : Official Journal of the International Society on Toxinology·Sean P BushEllen T Reibling

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Citations

Oct 4, 2015·Wilderness & Environmental Medicine·Michael E Mullins, Anah J Ali
Oct 29, 2015·Wilderness & Environmental Medicine·William R Witham
Aug 6, 2016·Biometals : an International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine·Vance G NielsenQuinlan Amos
Aug 23, 2016·Basic & Clinical Pharmacology & Toxicology·Vance G Nielsen, Philip A Losada
Jun 2, 2020·Toxicon : Official Journal of the International Society on Toxinology·David J LemonYoon Y Hwang
Dec 14, 2019·Toxicon : Official Journal of the International Society on Toxinology·Grady A FortnerGregory J Zarow

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