Antitoxin use and pediatric intensive care for viper bites in Rome, Italy

Area of Science:

• Toxicology
• Pediatric Critical Care

Background:

• Viper envenomation poses a significant risk, particularly in children due to body size and venom dose.
• Italy experiences uncommon viper bites, but severe complications necessitate specialized care.

Observation:

• A case series of 10 pediatric patients admitted to the Pediatric Intensive Care Unit (PICU) following viper bites in the Rome area over 5 years.
• Patients ranged from 3 to 15 years old, with a mean age of 6.9 years.
• Two children required respiratory support, and four needed hemodynamic support.

Findings:

• Five children experienced systemic involvement, while the remaining five had localized damage.
• The median PICU stay was 60 hours, with no reported mortality.
• Early antivenom administration is beneficial but carries risks for children.

Implications:

• Paediatric patients with viper bites require close monitoring in an ICU setting, especially younger children.
• Current recommendations emphasize careful consideration of antivenom use in pediatric cases.
• Effective management in the ICU is key to reducing morbidity and mortality from viper envenomation.