Handheld Point-of-Care Devices for Snakebite Coagulopathy: A Scoping Review.

Area of Science:

• Medical Science
• Toxicology
• Biotechnology

Background:

• Venom-induced consumption coagulopathy (VICC) is a severe snakebite complication.
• Current diagnostic methods like the 20-minute whole blood clotting test lack standardization and accuracy.
• Point-of-care (POC) devices offer potential for improved VICC diagnosis in remote settings.

Purpose of the Study:

• To review existing POC coagulation devices for VICC diagnosis.
• To identify mechanistic reasons for the failure of previously studied POC devices.
• To recommend promising POC devices for future clinical validation in snakebite patients.

Main Methods:

• Scoping review of literature on POC coagulation devices and VICC.
• Analysis of previously evaluated POC devices, including INR, ACT, aPTT, fibrinogen, and D-dimer assays.
• Identification and assessment of commercially available POC devices.

Main Results:

• Previous POC INR devices failed due to inaccurate endpoints or product discontinuation.
• Promising POC devices include those detecting fibrin clot formation and a novel device quantifying fibrinogen.
• Sixteen commercially available POC devices for various coagulation parameters were reviewed.

Conclusions:

• Novel POC devices detecting fibrin clot formation and quantifying fibrinogen show potential for VICC diagnosis.
• These devices could improve antivenom allocation, reduce administration time, and enhance clinical trial outcomes.
• Prospective clinical validation of these promising POC coagulation devices in snakebite studies is urgently required.