Severe Snakebite Envenoming in Intensive Care.

Area of Science:

• Toxicology
• Critical Care Medicine
• Herpetology

Background:

• Snakebites from exotic venomous species pose significant health risks, particularly to breeders in Europe and North America.
• Native rattlesnake bites also contribute to envenoming cases in North America.
• Severe envenoming can lead to multi-organ failure, paralysis, and tissue necrosis.

Purpose of the Study:

• To review the clinical syndromes associated with severe snake envenoming.
• To outline therapeutic options for managing severe snakebites in the intensive care setting.
• To aid physicians, particularly intensive care specialists, in recognizing and managing these rare but critical cases.

Main Methods:

• This is a review article synthesizing existing literature on severe snake envenoming.
• Focuses on clinical presentations and intensive care management strategies.
• Draws upon expertise in clinical toxicology and critical care medicine.

Main Results:

• Severe envenoming manifests as systemic failures including paralysis, respiratory compromise, circulatory instability, acute kidney injury, and coagulation disorders.
• Local effects like compartment syndrome and necrosis are common.
• Effective management requires a multidisciplinary approach, primarily led by intensive care physicians.

Conclusions:

• Intensive care physicians play a crucial role in managing severe snake envenoming due to its low incidence and complex clinical course.
• Understanding the spectrum of clinical syndromes and available intensive care interventions is vital for improving patient outcomes.
• Close collaboration between clinical toxicology and intensive care is essential for optimal patient management.