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Review

Novel Treatment Strategy for Patients with Venom-Induced Consumptive Coagulopathy from a Pit Viper Bite

Emergency Department, Ajou University School of Medicine, Suwon 16499, Gyeonggi-do, Korea
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Received: 22 March 2020 / Revised: 1 May 2020 / Accepted: 2 May 2020 / Published: 5 May 2020
(This article belongs to the Special Issue Novel Strategies for the Diagnosis and Treatment of Snakebites)
Pit viper venom commonly causes venom-induced consumptive coagulopathy (VICC), which can be complicated by life-threatening hemorrhage. VICC has a complex pathophysiology affecting multiple steps of the coagulation pathway. Early detection of VICC is challenging because conventional blood tests such as prothrombin time (PT) and activated partial thromboplastin time (aPTT) are unreliable for early-stage monitoring of VICC progress. As the effects on the coagulation cascade may differ, even in the same species, the traditional coagulation pathways cannot fully explain the mechanisms involved in VICC or may be too slow to have any clinical utility. Antivenom should be promptly administered to neutralize the lethal toxins, although its efficacy remains controversial. Transfusion, including fresh frozen plasma, cryoprecipitate, and specific clotting factors, has also been performed in patients with bleeding. The effectiveness of viscoelastic monitoring in the treatment of VICC remains poorly understood. The development of VICC can be clarified using thromboelastography (TEG), which shows the procoagulant and anticoagulant effects of snake venom. Therefore, we believe that TEG may be able to be used to guide hemostatic resuscitation in victims of VICC. Here, we aim to discuss the advantages of TEG by comparing it with traditional coagulation tests and propose potential treatment options for VICC. View Full-Text
Keywords: snake venoms; consumption coagulopathy; thromboelastography; antivenins; blood transfusion snake venoms; consumption coagulopathy; thromboelastography; antivenins; blood transfusion
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MDPI and ACS Style

Park, E.J.; Choi, S.; Kim, H.-H.; Jung, Y.S. Novel Treatment Strategy for Patients with Venom-Induced Consumptive Coagulopathy from a Pit Viper Bite. Toxins 2020, 12, 295. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050295

AMA Style

Park EJ, Choi S, Kim H-H, Jung YS. Novel Treatment Strategy for Patients with Venom-Induced Consumptive Coagulopathy from a Pit Viper Bite. Toxins. 2020; 12(5):295. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050295

Chicago/Turabian Style

Park, Eun J., Sangchun Choi, Hyuk-Hoon Kim, and Yoon S. Jung 2020. "Novel Treatment Strategy for Patients with Venom-Induced Consumptive Coagulopathy from a Pit Viper Bite" Toxins 12, no. 5: 295. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins12050295

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