HBO₂ in snake envenomation (atrox albinus rattlesnake): a case report in a human

A patient suffered from an envenomation that, at his hospitalization, was judged severe: Grade 3 out of 3, as defined in clinical studies for CroFab™ antidote [Crotalidae Polyvalent Immune Fab (Ovine)]. In addition to the usual antivenom treatment we applied adjunctive hyperbaric oxygen (HBO₂) therapy. Our aim was to facilitate better control of the lesions, already presenting as problematic wounds and at high risk of necrotizing soft tissue infection with compartment aspects. The regimen consisted of six treatments, one daily at 2.4 atmospheres absolute at 25 minutes x3 (75 minutes) at FiO₂=1, with two five-minute air breaks interposed. The therapy was well tolerated in spite of the patient's declared trait of claustrophobia. Our findings at a long-term follow up suggest that HBO₂ therapy may be reasonably and effectively administered at least in the post-acute phase of such occurrences.