DOI: http://dx.doi.org/10.18203/issn.2454-2156.IntJSciRep20151500

Effect of low dose ASV with supportive care in poisonous snake bites in Marathwada region, Aurangabad, Maharashtra, India

Mangala S. Borkar, Chandrakant G. Lahane, Akshay A. Kashid, Swati U. Chavan, Sandeep G. Uppod

Abstract


Background: Due to a large number of patients and severe scarcity of ASV with patches of unavailability and unaffordable high cost, low doses of ASV had to be compulsorily used for treatment of poisonous snakebites. The main objective is to study the effectiveness of low dose ASV (total <50 ml) in the management of poisonous snake bites in the scenario of global ASV scarcity.

Methods: Patients of snake bites with signs of envenomation were included in this observational, prospective study. Immediately, low dose (30 to 50 ml) of ASV was started after carefully testing intravenously. The patients were kept under intensive observation with supportive management (artificial ventilation, neostigmine-atropine, blood and fresh frozen plasma, as needed).  

Results: In the study of 309 patients, slight male preponderance was seen (161 males and 148 females).144 patients had vasculotoxic, 122 patients had neurotoxic and 43 patients had mixed type (both vasculotoxic and neurotoxic) of envenomation. Average dose of ASV given was 35.30 ml. 297 patients survived, 12 died. In 42 cases having both neurological and vasculotoxic (mixed) snake bite, 7 patients (16.66%) died. Among 122 neuroparalytic cases, 5 (4.0983%) died. We did not get any mortality in the 145 cases of vasculotoxic snake bites. There was no statistically significant difference in the outcome of the patients whether they received higher or low doses of ASV.

Conclusions: There was no significant difference in the outcome of poisonous snake bites whether low dose (<50 ml) or high doses (>50 ml) of ASV were given and practically all the victims who came on time, survived with low doses of ASV. This is very important in developing countries like India where there is high incidence of poisonous snake bites and scarcity of ASV.

Keywords


Low dose ASV (anti-snake venom), Vasculotoxic, Neuroparalytic, HBD, VAP

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