Clinical Features and Management of Snakebite Envenoming in French Guiana
The management of snakebite (SB) envenoming in French Guiana (FG) is based on symptomatic measures and antivenom (AV) administration (Antivipmyn Tri<sup>®</sup>; Instituto Bioclon—Mexico). Our study aimed to assess clinical manifestations, the efficacy, and safety of Antivipmyn Tri<su...
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doaj-4d4a4a15028747fca0c8e756a577f01f2020-11-25T03:57:27ZengMDPI AGToxins2072-66512020-10-011266266210.3390/toxins12100662Clinical Features and Management of Snakebite Envenoming in French GuianaDabor Resiere0Stéphanie Houcke1Jean Marc Pujo2Claire Mayence3Cyrille Mathien4Flaubert NkontCho5Nicaise Blaise6Magalie Pierre Demar7Didier Hommel8Hatem Kallel9Intensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaIntensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaEmergency Department, Cayenne General Hospital, Cayenne 97300, French GuianaIntensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaIntensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaPharmacy Department, Cayenne General Hospital, Cayenne 97300, French GuianaPharmacy Department, Cayenne General Hospital, Cayenne 97300, French GuianaLaboratory department, Cayenne General Hospital, Cayenne 97300, French GuianaIntensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaIntensive Care Unit, Cayenne General Hospital, Cayenne 97300, French GuianaThe management of snakebite (SB) envenoming in French Guiana (FG) is based on symptomatic measures and antivenom (AV) administration (Antivipmyn Tri<sup>®</sup>; Instituto Bioclon—Mexico). Our study aimed to assess clinical manifestations, the efficacy, and safety of Antivipmyn Tri<sup>®</sup> in the management of SB. Our study is a prospective observational work. It was conducted in the Intensive Care Unit (ICU) of Cayenne General Hospital between January 1st, 2016 and December 31, 2019. We included all patients hospitalized for SB envenoming. Our study contained three groups (without AV, three vials, and six vials Antivipmyn Tri<sup>®</sup>). During the study period, 133 patients were included. The main clinical symptoms were edema (98.5%), pain (97.7%), systemic hemorrhage (18%), blister (14.3%), and local hemorrhage (14.3%). AV was prescribed for 83 patients (62.3%), and 17 of them (20%) developed early adverse reactions. Biological parameters at admission showed defibrinogenation in 124 cases (93.2%), International Normalized Ratio (INR) > 2 in 104 cases (78.2%), and partial thromboplastin time (PTT) > 1.5 in 74 cases (55.6%). The time from SB to AV was 9:00 (5:22–20:40). The median time from SB to achieve a normal dosage of fibrinogen was 47:00 vs. 25:30, that of Factor II was 24:55 vs. 15:10, that of Factor V was 31:42 vs. 19:42, and that of Factor VIII was 21:30 vs. 10:20 in patients without and with AV, respectively, (<i>p </i>< 0.001 for all factors). Patients receiving Antivipmyn Tri<sup>®</sup> showed a reduction in the time to return to normal clotting tests, as compared to those who did not. We suggest assessing other antivenoms available in the region to compare their efficacy and safety with Antivipmyn Tri<sup>®</sup> in FG.https://www.mdpi.com/2072-6651/12/10/662snakebite envenomingclinical manifestationsFrench Guiana<i>Bothrops atrox</i>Antivipmyn Tri<sup>®</sup> |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dabor Resiere Stéphanie Houcke Jean Marc Pujo Claire Mayence Cyrille Mathien Flaubert NkontCho Nicaise Blaise Magalie Pierre Demar Didier Hommel Hatem Kallel |
spellingShingle |
Dabor Resiere Stéphanie Houcke Jean Marc Pujo Claire Mayence Cyrille Mathien Flaubert NkontCho Nicaise Blaise Magalie Pierre Demar Didier Hommel Hatem Kallel Clinical Features and Management of Snakebite Envenoming in French Guiana Toxins snakebite envenoming clinical manifestations French Guiana <i>Bothrops atrox</i> Antivipmyn Tri<sup>®</sup> |
author_facet |
Dabor Resiere Stéphanie Houcke Jean Marc Pujo Claire Mayence Cyrille Mathien Flaubert NkontCho Nicaise Blaise Magalie Pierre Demar Didier Hommel Hatem Kallel |
author_sort |
Dabor Resiere |
title |
Clinical Features and Management of Snakebite Envenoming in French Guiana |
title_short |
Clinical Features and Management of Snakebite Envenoming in French Guiana |
title_full |
Clinical Features and Management of Snakebite Envenoming in French Guiana |
title_fullStr |
Clinical Features and Management of Snakebite Envenoming in French Guiana |
title_full_unstemmed |
Clinical Features and Management of Snakebite Envenoming in French Guiana |
title_sort |
clinical features and management of snakebite envenoming in french guiana |
publisher |
MDPI AG |
series |
Toxins |
issn |
2072-6651 |
publishDate |
2020-10-01 |
description |
The management of snakebite (SB) envenoming in French Guiana (FG) is based on symptomatic measures and antivenom (AV) administration (Antivipmyn Tri<sup>®</sup>; Instituto Bioclon—Mexico). Our study aimed to assess clinical manifestations, the efficacy, and safety of Antivipmyn Tri<sup>®</sup> in the management of SB. Our study is a prospective observational work. It was conducted in the Intensive Care Unit (ICU) of Cayenne General Hospital between January 1st, 2016 and December 31, 2019. We included all patients hospitalized for SB envenoming. Our study contained three groups (without AV, three vials, and six vials Antivipmyn Tri<sup>®</sup>). During the study period, 133 patients were included. The main clinical symptoms were edema (98.5%), pain (97.7%), systemic hemorrhage (18%), blister (14.3%), and local hemorrhage (14.3%). AV was prescribed for 83 patients (62.3%), and 17 of them (20%) developed early adverse reactions. Biological parameters at admission showed defibrinogenation in 124 cases (93.2%), International Normalized Ratio (INR) > 2 in 104 cases (78.2%), and partial thromboplastin time (PTT) > 1.5 in 74 cases (55.6%). The time from SB to AV was 9:00 (5:22–20:40). The median time from SB to achieve a normal dosage of fibrinogen was 47:00 vs. 25:30, that of Factor II was 24:55 vs. 15:10, that of Factor V was 31:42 vs. 19:42, and that of Factor VIII was 21:30 vs. 10:20 in patients without and with AV, respectively, (<i>p </i>< 0.001 for all factors). Patients receiving Antivipmyn Tri<sup>®</sup> showed a reduction in the time to return to normal clotting tests, as compared to those who did not. We suggest assessing other antivenoms available in the region to compare their efficacy and safety with Antivipmyn Tri<sup>®</sup> in FG. |
topic |
snakebite envenoming clinical manifestations French Guiana <i>Bothrops atrox</i> Antivipmyn Tri<sup>®</sup> |
url |
https://www.mdpi.com/2072-6651/12/10/662 |
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