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Published on: July 22, 2017
A localizing circumferential compression device delayed death after artificial eastern diamondback rattlesnake
Jason B Hack1, Babatunde Orogbemi, Jocelyn M Deguzman
1Department of Emergency Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA. jhack@lifespan.org
Abstract:
Nearly all prior studies to delay onset of systemic toxicity and death after snake bite use a model of distal extremity envenomation. In the first of a series of planned studies using snake venoms with different toxicity profiles, the application of a novel device in a new model of torso envenomation in the setting of Eastern Coral Snake (Micrurus fulvius) venom (a potent neurotoxin) envenomation showed promise by delaying systemic intoxication. In this pilot study, we investigated this novel localizing circumferential compression (LoCC) device's ability to delay onset of life threatening systemic toxicity after Eastern Diamondback Rattlesnake (Crotalus adamanteus) envenomation, a potent hemotoxic and myotoxic venom. With university approval, four juvenile female pigs (22-25 kg) were anesthetized, sedated, and intubated but not paralyzed to allow for spontaneous respirations. Each animal was injected subcutaneously with 50 mg of C. adamanteus venom in identical preselected areas of the trunk. After 1 min, two treatment animals had the LoCC device applied; two control animals had no intervention. Vital signs were recorded every 10 min for the first 2 h and every 30 min thereafter. Endpoints included cardiovascular collapse (fatal arrhythmia, loss of mean arterial pressure, or pulse) or respiratory arrest (<3 breaths/min, saturation < 80%) or survival to 7 h. The pigs in the treatment group reached an endpoint at an average time of 355 (+/-65) min compared with control 32 (+/-3.5) min (p < 0.04). In this pilot study, the LoCC device significantly delayed onset of systemic symptoms and death after torso envenomation with Eastern Diamondback Rattlesnake venom in this model.
Insights
A novel localizing circumferential compression (LoCC) device significantly delayed systemic toxicity and death in a torso envenomation model using Eastern Diamondback Rattlesnake venom. This device shows promise for treating severe snakebites.
Area of Science:
- Toxicology
- Emergency Medicine
- Biomedical Engineering
Background:
- Snakebite envenomation is a significant health concern, often studied using extremity models.
- Torso envenomation presents unique challenges due to rapid systemic absorption.
- Existing treatments primarily focus on distal envenomations.
Purpose of the Study:
- To evaluate the efficacy of a novel localizing circumferential compression (LoCC) device in delaying systemic toxicity after torso envenomation.
- To assess the LoCC device's impact on delaying life-threatening symptoms following Eastern Diamondback Rattlesnake (Crotalus adamanteus) venom injection.
- To establish a new preclinical model for studying torso envenomation.
Main Methods:
- A pilot study using four juvenile pigs (22-25 kg) with induced Eastern Diamondback Rattlesnake venom envenomation in the torso.
- Two pigs received the LoCC device application within 1 minute of venom injection; two served as controls.
- Continuous monitoring of vital signs and assessment of predefined endpoints for systemic toxicity and survival up to 7 hours.
Main Results:
- The LoCC device group demonstrated a significant delay in reaching systemic toxicity endpoints (average 355 min) compared to the control group (average 32 min).
- The p-value for the difference in time to endpoint was less than 0.04, indicating statistical significance.
- No paralysis was induced in the animals, allowing for assessment of spontaneous respiratory function.
Conclusions:
- The localizing circumferential compression (LoCC) device significantly delays the onset of systemic toxicity and death in a torso envenomation model using Eastern Diamondback Rattlesnake venom.
- This novel device shows potential as an intervention for managing severe snakebite cases, particularly those involving torso envenomation.
- Further studies are warranted to explore the LoCC device's efficacy with various venom types and in different envenomation scenarios.
