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Hemostasis dynamics during coagulopathy resulting from Echis envenomation
Georges Mion1, Sébastien Larréché, Alain Benois
1Pôle ARTE (Anesthésie Réanimations Thorax Exploration), Groupe hospitalier Cochin-Broca-Hôtel-Dieu, Paris, France.
Toxicon : Official Journal of the International Society on Toxinology
|September 28, 2013
Summary
Echis envenomation severely impacts hemostasis for up to 10 days without treatment. Antivenom therapy rapidly corrects coagulopathy, restoring normal clotting function within hours in patients bitten by these African vipers.
Area of Science:
- Medical Research
- Toxicology
- Hematology
Background:
- Echis envenomation is a significant cause of coagulopathy in Africa.
- Understanding the time course of hemostasis disorders is crucial for effective treatment.
Purpose of the Study:
- To graphically describe the time course of hemostasis test results in Echis envenomation.
- To evaluate the efficacy of antivenom therapy in correcting hemostasis disorders.
Main Methods:
- Prospective study over 12 years in Africa.
- Inclusion of 60 patients with Echis envenomation.
- Monitoring of fibrinogen levels, prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet count.
Main Results:
- Spontaneous resolution of hemostasis disorders took 7.5 days for fibrinogen, 5.8 days for PT, and 4.7 days for aPTT.
- Antivenom therapy corrected these parameters within 40 hours (fibrinogen), 25 hours (PT), and 10 hours (aPTT).
- Bleeding occurred in 50% of patients; thrombopenia was uncommon.
Conclusions:
- Echis envenomation causes prolonged hemostasis impairment without antivenom.
- Antivenom is highly effective in rapidly reversing coagulopathy associated with Echis bites.
- This study provides a valuable chart for understanding the clinical evolution of Echis envenomation.
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