Low dose of snake antivenom is as effective as high dose in patients with severe neurotoxic snake envenoming
Low dose of snake antivenom is as effective as high dose in patients with severe neurotoxic snake envenoming
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DOI：
10.1136/emj.2004.020727
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发表时间：
2005-06-01
影响因子：
3.1
通讯作者：
Jindal, SK
中科院分区：
文献类型：
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作者：
Agarwal, R;Aggarwal, AN;Jindal, SK
本研究的目的是评估两种不同剂量方案对严重神经毒性蛇咬伤患者预后的影响，对诊断为严重神经毒性蛇咬伤的住院患者进行了4年的回顾性分析。在这项研究中，55名因严重神经毒性中毒而需要呼吸机支持的蛇咬伤患者接受了150毫升多价蛇毒血清（SAV）（低剂量SAV组，n = 28）或100毫升SAV，然后每6小时100毫升SAV，直到神经症状恢复（高剂量组，n = 27）。高剂量组SAV的中位剂量为600 ml（范围300 ~ 1600）。低剂量组机械通气持续时间（中位数47.5小时，范围14 ~ 248）与高剂量组相似（中位数44小时，范围6 ~ 400）。两组患者在重症监护病房的平均（SD）停留时间相似。高剂量组死亡3例；低剂量组2例出现神经系统后遗症。所有其他患者均有所改善，无残余神经功能缺损，均出院。我们的结论是，在严重神经毒性蛇中毒患者的管理中，使用低剂量SAV和使用高剂量SAV的方案没有区别。
The objective of this study was to evaluate the effects of two different dosage protocols on the outcome of patients with severe neurotoxic snake envenoming, using a retrospective analysis of patients admitted with a diagnosis of severe neurotoxic snake bite over a 4 year period. In the study, 55 snake bite victims requiring ventilatory support for severe neurotoxic envenoming received either 150 ml of polyvalent snake antivenom (SAV) ( low dose SAV group, n = 28) or 100 ml of SAV at presentation followed by 100 ml every 6 hours until recovery of neurological manifestations ( high dose group, n = 27). The median dose of SAV in the high dose group was 600 ml ( range 300 to 1600). The duration of mechanical ventilation in the low dose group ( median 47.5 hours; range 14 to 248) was similar to that in the high dose group ( median 44 hours; range 6 to 400). The mean (SD) duration of intensive care unit stay was similar in the two groups. There were three deaths in the high dose group; two patients in the low dose group had neurological sequelae. All other patients improved, had no residual neurological deficit, and were discharged. We conclude that there is no difference between a protocol using lower doses of SAV and one with higher doses in the management of patients with severe neurotoxic snake envenoming.