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Thromboelastography Use to Guide Resuscitation and Antivenom Administration after Gaboon Viper Bite
Justin D Faulkner1, Christopher J Carballo1, Elizabeth Acquista1
1Department of General Surgery & Surgical Critical Care, New Hanover Regional Medical Center, Wilmington, NC, USA.
The American Surgeon
|July 11, 2023
Summary
Gaboon viper bites are rare but dangerous, causing severe bleeding disorders. This case highlights successful management using antivenom, blood products guided by thromboelastography, and early continuous renal replacement therapy for survival.
Area of Science:
- Herpetology
- Toxicology
- Emergency Medicine
Background:
- Gaboon viper (Bitis gabonica) venom is a potent hemotoxin causing coagulopathy and necrosis.
- Human envenomations are rare, with limited literature on management protocols.
- Effective treatment strategies for severe Gaboon viper envenomation are crucial.
Observation:
- A 29-year-old male presented with severe coagulopathy 3 hours post-Gaboon viper envenomation.
- Massive resuscitation, multiple antivenom doses, and blood products guided by thromboelastography (TEG) were administered.
- Early continuous renal replacement therapy (CRRT) was initiated to manage acidosis and acute renal failure.
Findings:
- The combined approach of TEG-guided resuscitation, antivenom, and early CRRT effectively corrected venom-induced consumptive coagulopathy.
- The patient survived a life-threatening envenomation due to prompt and comprehensive medical intervention.
Implications:
- This case underscores the importance of aggressive management for Gaboon viper envenomations.
- TEG and CRRT can be valuable tools in managing complex coagulopathies and organ dysfunction following snakebites.
- Further research into optimal treatment protocols for Gaboon viper envenomations is warranted.
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