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- Title
Comparative analysis of high-dose anti-snake venom VS low dose anti-snake venom on morbidity and mortality following poisonous snake bites.
- Authors
Fazal, Afreen; Nasir, Shua; Shehbaz, Lal; Mumtaz, Huma; Asim, Syed Jehanzeb
- Abstract
Background: Snake bite is an important preventable health hazard. Patients with snake envenomation present to the emergency department with significant morbidity and mortality and emergency healthcare professionals are faced with the challenge of deciding an optimal anti-snake venom (ASV) dose. Objective: To compare the effect of administration of two different dosage regiments of ASV (high versus low) on the morbidity and mortality among patients following snake envenomation. Material and Methods: This prospective, cohort was conducted upon a sample of 114 snake bite patients (chosen via non-probability - consecutive sampling), of all genders and aged 18 to 60 years, presenting to the study setting from January 2016 to December 2020. The patients were randomly designated into two groups-A (High Dose ASV Regimen - Intermittent bolus dosage of 100 ml of ASV as a loading dose followed by 50 ml every 6-hours till whole blood coagulation time (CT) became normal) and B (low dose ASV Regimen - 30 ml of ASV as a loading dose followed by 30ml continuous infusion every 6-hours till coagulation time became normal). The data pertaining to treatment was recorded onto a structured questionnaire and analyzed using SPSS version 21 and Excel 2016. Results: Among the 114-patients enrolled in to the study, 72.81% were males, while the remaining 27.19% were females. The mean age of sample stood at 31-years (SD±11). In patients with mild, moderate and severe envenomation, the dosage requirements needed to obtain a normal CT were 137.5 ml, 343.8 ml and 433.3 ml in Group A - High Dose Regimen (HDR) and 128.6 ml, 221.3 ml and 213.7 ml for Group B - Low Dose Regimen (LDR). In the lowdose group there were 5-deaths giving a mortality rate of 8.78%, 9-(15.79%) required dialysis and 3(5.26%) required ventilatory support. In the high-dose group there were seven deaths giving a mortality rate of 12.28%, 13(22.8%) required dialysis and 3(5.26%) required ventilator support. The average hospital stay for the low-dose group was 8.42 days while that of the high-dose group was 9.02 days. Conclusion: After careful consideration, it can be concluded that the low dose regimen yield a better patient outcome in terms of anti-snake venom volume used, morbidity and mortality entailed and the hospital stay.
- Subjects
SNAKEBITES; POISONOUS snakes; VENOM; MEDICAL personnel; BLOOD coagulation; COMPARATIVE studies
- Publication
Pakistan Journal of Surgery, 2023, Vol 39, Issue 1, p50
- ISSN
0258-8552
- Publication type
Article