In northern Vietnam, a vast majority of the most severe envenomed patients are bitten by Bungarus multicinctus. Hitherto, these victims have received supportive care only. The aims of this study were to assess the possible efficacy and side effects of a newly produced antivenom.
Venomous snakebites constitute a serious health problem in many Asian countries. In Vietnam, the burden of snakebite on the public health stimulated Calmette to conduct original studies at the Vaccine Institute in Saigon over a hundred years ago and to develop the first snake antivenom ever. In northern Vietnam, a vast majority of the most severe envenomed patients are bitten by Bungarus multicinctus, which is the only krait species giving rise to significant morbidity and mortality in the area. Its venom contains toxins which can cause severe neuromuscular blockade but which do not give rise to swelling or necrosis at the site of the bite. Supportive care is an important part of the management of snakebites, but antivenom administration is the mainstay therapy in the majority of medically significant envenomings. Such specific therapy may dramatically reduce the consequences of the envenomation. In Vietnam, no specific antivenom against B. multicinctus has been available until recently when it has produced for clinical use.
Study Type
INTERVENTIONAL
Purpose
TREATMENT
Masking
NONE
Enrollment
81
Five to ten ampoules of antivenom, depending on severity of muscle paralysis, were diluted with isotonic glucose solution to have total 50 ml and infused intravenously by electric pump during one hour. After a period of 6-8 hours, a second infusion was administered, under similar condition to the first, if no clinical improvement or adverse reaction had been noted. The patients also received supportive care such as intubation, ventilation...if necessary.
Supportive Care only (endotracheal intubation, mechanical ventilation...)
Vietnam Poison Control Center, Bach Mai Hospital, HMU
Hanoi, Vietnam
duration of mechanical ventilation
Time frame: the length of ICU stay
clinical course during ICU stay
Time frame: the length of ICU stay
complications (Ventilator associated pneumonia...)
Time frame: the length of ICU stay
adverse effects (anaphylaxis, serum sickness...)
Time frame: the length of ICU stay
hyponatremia, renal and liver function
Time frame: the length of ICU stay
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.