Snake venom coagulopathy: Use and abuse of blood products in the treatment of pit viper envenomation
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An antivenin resistant, IVIg-corticosteroids responsive viper induced thrombocytopenia
2022, Toxicology ReportsCitation Excerpt :VIT is thus a well-known complication which remains of unclear etiology in North America, and even less described in the European countries; such discrepancy can be due to both intrinsic differences among venoms and different antivenin treatments. The course of VIT is known to be extremely variable: rattlesnake VIT is known to usually improve immediately after AV administration [16,17], but with an incomplete and variable effect [18]; a retrospective review of all patients admitted for rattlesnake envenomation in California over a period of about 20 years concluded that usually an immediate antivenom treatment improves VIT in a dosage independent manner and that the clinical significance remains uncertain in absence of bleeding [11]. In preliminary studies, thrombocytopenia improved immediately also after Fab antivenom administration, but recurred, necessitating repeat dosing [19], posing the question of its efficacy in improving VIT.
Retrospective Documentation of a Confirmed White-Lipped Green Pit Viper (Trimeresurus albolabris Gray, 1842) Bite in the South-Central Hills of Nepal
2019, Wilderness and Environmental MedicineCitation Excerpt :This has been reported previously in Hong Kong.22 FFP supplies clotting factors such as fibrinogens that can be activated by the circulating venom toxins and those toxins absorbed by the uptake of additional venom possibly sequestered at the bite site.50,51 A recently conducted clinical trial investigating envenomed patients with consumptive coagulopathy52 suggested that using FFP and antivenom together restored clotting factors more rapidly and reduced clotting time and the amount of antivenom required.
Benefits of using heterologous polyclonal antibodies and potential applications to new and undertreated infectious pathogens
2016, VaccineCitation Excerpt :Safety of snake antivenins has improved with antibody fractionation and modern processing. Whole IgG rattlesnake antivenin (e.g. Antivenin Crotalidae Polyvalent ACP) was associated with a 18–50% frequency of immediate and delayed reactions [77–83]. This was more than halved after the removal of Fc and implantation of modern purification methods (e.g. Crofab®) [63,67,84–93,65,94].
Wilderness medical society practice guidelines for the treatment of pitviper envenomations in the United States and Canada
2015, Wilderness and Environmental MedicineCitation Excerpt :Blood product transfusion (including packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets) may help maintain normal hematocrit in the case of severe bleeding; however, unlike antivenom, transfusion does not reverse or improve coagulopathies. Therefore, antivenom should be given initially and considered the mainstay of therapy, with transfusions reserved for only severe life-threatening hemorrhage or anemia refractory to antivenom treatment.123 ( Recommendation grade: 1C)
Venomous Bites and Stings
2013, Current Problems in SurgeryVenomous Snakebites in North America
2012, Emergency Medicine: Clinical Essentials, SECOND EDITION