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Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom
المؤلفون المشاركون
Sharma, Sanjib Kumar
Taylor, Walter R.
Chappuis, François
Alirol, Emilie
Shrestha, Suman
Jha, Rupesh
Parajuli, Surya B.
Shrestha, Deekshya
Shrestha, Surya Jyoti
Bista, Amir
Warrell, David
Kuch, Ulrich
Ghimire, Anup
المصدر
العدد
المجلد 2019، العدد 2019 (31 ديسمبر/كانون الأول 2019)، ص ص. 1-12، 12ص.
الناشر
Hindawi Publishing Corporation
تاريخ النشر
2019-05-02
دولة النشر
مصر
عدد الصفحات
12
التخصصات الرئيسية
الملخص EN
Diagnosing and treating acute severe and recurrent antivenom-related anaphylaxis (ARA) is challenging and reported experience is limited.
Herein, we describe our experience of severe ARA in patients with neurotoxic snakebite envenoming in Nepal.
Patients were enrolled in a randomised, double-blind trial of high vs.
low dose antivenom, given by intravenous (IV) push, followed by infusion.
Training in ARA management emphasised stopping antivenom and giving intramuscular (IM) adrenaline, IV hydrocortisone, and IV chlorphenamine at the first sign/s of ARA.
Later, IV adrenaline infusion (IVAI) was introduced for patients with antecedent ARA requiring additional antivenom infusions.
Preantivenom subcutaneous adrenaline (SCAd) was introduced in the second study year (2012).
Of 155 envenomed patients who received ≥ 1 antivenom dose, 13 (8.4%), three children (aged 5−11 years) and 10 adults (18−52 years), developed clinical features consistent with severe ARA, including six with overlapping signs of severe envenoming.
Four and nine patients received low and high dose antivenom, respectively, and six had received SCAd.
Principal signs of severe ARA were dyspnoea alone (n=5 patients), dyspnoea with wheezing (n=3), hypotension (n=3), shock (n=3), restlessness (n=3), respiratory/cardiorespiratory arrest (n=7), and early (n=1) and late laryngeal oedema (n=1); rash was associated with severe ARA in 10 patients.
Four patients were given IVAI.
Of the 8 (5.1%) deaths, three occurred in transit to hospital.
Severe ARA was common and recurrent and had overlapping signs with severe neurotoxic envenoming.
Optimising the management of ARA at different healthy system levels needs more research.
This trial is registered with NCT01284855.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Sharma, Sanjib Kumar& Alirol, Emilie& Ghimire, Anup& Shrestha, Suman& Jha, Rupesh& Parajuli, Surya B.…[et al.]. 2019. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Journal of Tropical Medicine،Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1192312
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Sharma, Sanjib Kumar…[et al.]. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Journal of Tropical Medicine No. 2019 (2019), pp.1-12.
https://search.emarefa.net/detail/BIM-1192312
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Sharma, Sanjib Kumar& Alirol, Emilie& Ghimire, Anup& Shrestha, Suman& Jha, Rupesh& Parajuli, Surya B.…[et al.]. Acute Severe Anaphylaxis in Nepali Patients with Neurotoxic Snakebite Envenoming Treated with the VINS Polyvalent Antivenom. Journal of Tropical Medicine. 2019. Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1192312
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references
رقم السجل
BIM-1192312
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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