Intensive Care Unit, Cayenne General Hospital, 97300 Cayenne, French Guiana, France.
Intensive Care Unit, Martinique University Hospital, 97261 Martinique, France.
Toxins (Basel). 2020 Oct 19;12(10):662. doi: 10.3390/toxins12100662.
The management of snakebite (SB) envenoming in French Guiana (FG) is based on symptomatic measures and antivenom (AV) administration (Antivipmyn Tri; Instituto Bioclon-Mexico). Our study aimed to assess clinical manifestations, the efficacy, and safety of Antivipmyn Tri 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 1 January 2016 and 31 December 2019. We included all patients hospitalized for SB envenoming. Our study contained three groups (without AV, three vials, and six vials Antivipmyn Tri). 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, ( < 0.001 for all factors). Patients receiving Antivipmyn Tri 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 in FG.
法属圭亚那（French Guiana，FG）的蛇咬伤（snakebite，SB）管理基于症状治疗和抗蛇毒血清（antivenom，AV）的使用（Antivipmyn Tri；Instituto Bioclon-Mexico）。我们的研究旨在评估 Antivipmyn Tri 在 SB 管理中的临床表现、疗效和安全性。我们的研究是一项前瞻性观察性工作。它于 2016 年 1 月 1 日至 2019 年 12 月 31 日在卡宴综合医院的重症监护病房（intensive care unit，ICU）进行。我们纳入了所有因 SB 中毒住院的患者。我们的研究包含三个组（无 AV、三瓶 AV 和六瓶 AV）。在研究期间，共纳入了 133 名患者。主要的临床症状是水肿（98.5%）、疼痛（97.7%）、全身性出血（18%）、水疱（14.3%）和局部出血（14.3%）。83 名患者（62.3%）开具了 AV，其中 17 名（20%）出现早期不良反应。入院时的生物学参数显示 124 例（93.2%）有纤维蛋白原降解，104 例（78.2%）国际标准化比值（international normalized ratio，INR）>2，74 例（55.6%）部分凝血活酶时间（partial thromboplastin time，PTT）>1.5。从 SB 到 AV 的时间为 9:00（5:22-20:40）。从 SB 到纤维蛋白原达到正常剂量的中位时间分别为 47:00（无 AV）和 25:30（有 AV），因子 II 为 24:55（无 AV）和 15:10（有 AV），因子 V 为 31:42（无 AV）和 19:42（有 AV），因子 VIII 为 21:30（无 AV）和 10:20（有 AV）（所有因素的 P<0.001）。与未使用 AV 的患者相比，使用 Antivipmyn Tri 的患者凝血检测恢复正常的时间更短。我们建议评估该地区其他可用的抗蛇毒血清，以比较它们在 FG 中的疗效和安全性。
