Hack Jason B, Deguzman Jocelyn M, Brewer Kori L, Meggs William J, O'Rourke Dorcas
Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.
J Emerg Med. 2011 Jul;41(1):102-7. doi: 10.1016/j.jemermed.2010.04.027. Epub 2010 May 26.
Pressure immobilization bandages have been shown to delay onset of systemic toxicity after Eastern coral snake (Micrurus fulvius) envenomation to the distal extremity.
To assess the efficacy of a novel compression device in delaying onset of systemic toxicity after truncal envenomations with Eastern coral snake (Micrurus fulvius) venom in a porcine model.
With University approval, nine juvenile pigs (11 kg to 22 kg) were sedated, anesthetized, and intubated but not paralyzed to ensure continuous spontaneous respirations in a university animal laboratory. Each animal was injected subcutaneously with 10 mg of M. fulvius venom in a pre-selected area of the trunk. After 1 min, six animals had the application of a novel, localizing circumferential compression (LoCC) device applied to the bite site (treatment group) and three animals had no treatment (control group). The device was composed of a rigid polymer clay form molded into a hollow fusiform shape with an internal dimension of 8 × 5 × 3 cm and an elastic belt wrapped around the animal securing the device in place. Vital signs were recorded at 30-min intervals. End points included a respiratory rate below 3 breaths/min, oxygen saturation < 80%, or survival to 8 h. Survival to 8 h was analyzed using Fisher's exact test, with p < 0.05 indicating significance. Survival analysis was performed using the Mantel-Cox test to assess time to death with outcomes represented in a Kaplan-Meier Cumulative survival plot.
Five of the six pigs in the treatment group survived 8 h (293-480 min). None of the control pigs survived to 8 h (Fisher's exact p = 0.04), with mean time of respiratory failure 322 min (272-382 min). Survival analysis showed a significant delay in time to event in the treatment group compared to the control group (p = 0.04).
The LoCC device used in this study delayed the onset of systemic toxicity and significantly increased survival time after artificial truncal envenomation by Eastern coral snake venom.
压力固定绷带已被证明可延迟东部珊瑚蛇（Micrurus fulvius）毒液注入远端肢体后全身毒性的发作。
在猪模型中评估一种新型加压装置对延迟东部珊瑚蛇（Micrurus fulvius）毒液躯干中毒后全身毒性发作的效果。
经大学批准，在大学动物实验室对9只幼猪（11千克至22千克）进行镇静、麻醉和插管，但不进行麻痹，以确保持续自主呼吸。每只动物在躯干的预选区域皮下注射10毫克东部珊瑚蛇毒液。1分钟后，6只动物在咬伤部位应用一种新型的局部环形加压（LoCC）装置（治疗组），3只动物不进行治疗（对照组）。该装置由模制成中空梭形的刚性聚合物粘土制成，内部尺寸为8×5×3厘米，并用弹性带缠绕动物以将装置固定到位。每隔30分钟记录生命体征。终点指标包括呼吸频率低于3次/分钟、氧饱和度<80%或存活至8小时。使用Fisher精确检验分析存活至8小时的情况，p<0.05表示有显著性差异。使用Mantel-Cox检验进行生存分析，以评估死亡时间，结果以Kaplan-Meier累积生存图表示。
治疗组的6只猪中有5只存活了8小时（293 - 480分钟）。对照组的猪均未存活至8小时（Fisher精确检验p = 0.04），呼吸衰竭的平均时间为322分钟（272 - 382分钟）。生存分析表明，与对照组相比，治疗组发生事件的时间显著延迟（p = 0.04）。
本研究中使用的LoCC装置延迟了全身毒性的发作，并显著增加了东部珊瑚蛇毒液人工躯干中毒后的存活时间。
