Please use this identifier to cite or link to this item:
http://repository.kln.ac.lk/handle/123456789/16015
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Isbister, G.K. | |
dc.contributor.author | Jayamanne, S. | |
dc.contributor.author | Mohamed, F. | |
dc.contributor.author | Dawson, A.H. | |
dc.contributor.author | Maduwage, K. | |
dc.contributor.author | Gawarammana, I. | |
dc.contributor.author | Lalloo, D.G. | |
dc.contributor.author | de Silva, H.J. | |
dc.contributor.author | Scorgie, F.E. | |
dc.contributor.author | Lincz, L.F. | |
dc.contributor.author | Buckley, N.A. | |
dc.date.accessioned | 2017-01-23T06:44:22Z | |
dc.date.available | 2017-01-23T06:44:22Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Journal of Thrombosis and Haemostasis. 2017; 15(4): 645-654 | en_US |
dc.identifier.issn | 1538-7933 (Print) | |
dc.identifier.issn | 1538-7836 (Electronic) | |
dc.identifier.issn | 1538-7836 (Linking) | |
dc.identifier.uri | http://repository.kln.ac.lk/handle/123456789/16015 | |
dc.description | Indexed in MEDLINE | en_US |
dc.description.abstract | BACKGROUND: Russell's viper (Daboia russelii) envenoming is a major health issue in South Asia and causes venom induced consumption coagulopathy (VICC). OBJECTIVES: We investigated the effect of fresh frozen plasma (FFP) and two antivenom doses in correcting VICC. METHODS: We undertook an open-label randomized controlled trial in patients with VICC at two Sri Lankan hospitals. Patients with suspected Russell's viper bites and coagulopathy were randomly allocated (1:1) high-dose antivenom (20 vials) or low-dose antivenom (10 vials) plus 4U FFP. The primary outcome was the proportion of patients with an international normalized ratio (INR)<2, 6h post-antivenom. Secondary outcomes included anaphylaxis, major haemorrhage, death and clotting factor recovery. RESULTS: From 214 eligible patients, 141 were randomized; 71 to high-dose antivenom, 70 to low-dose antivenom/FFP; five had no post-antivenom bloods. The groups were similar except for a delay of 1h in antivenom administration for FFP patients. 6h post-antivenom 23/69 (33%) patients allocated high-dose antivenom had an INR<2 compared with 28/67 (42%) allocated low-dose antivenom/FFP [absolute difference 8%;95%Confidence Interval:-8% to 25%]. 15 patients allocated FFP did not receive it. Severe anaphylaxis occurred equally frequently in each group. One patient given FFP developed transfusion related acute lung injury. Three deaths occurred in low-dose/FFP patients including one intracranial haemorrhage. There was no difference in recovery rates of INR or fibrinogen, but more rapid initial recovery of factor V and X in FFP patients. CONCLUSION: FFP post-antivenom in Russell's viper bites didn't hasten recovery of coagulopathy. Low-dose antivenom/FFP did not worsen VICC, suggesting low-dose antivenom is sufficient. This article is protected by copyright. All rights reserved. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Wiley-Blackwell | en_US |
dc.subject | Snake Bites | en_US |
dc.subject | Snake Bites-therapy | en |
dc.subject | Russell's Viper | en |
dc.subject | Snake Venoms | en |
dc.subject | Antivenins | en |
dc.subject | Antivenins-therapeutic use | en |
dc.subject | Blood Coagulation | en |
dc.subject | Disseminated Intravascular Coagulation | en |
dc.subject | Plasma | en |
dc.subject | Viper Venoms | en |
dc.subject | Sri Lanka | en |
dc.subject | Randomized Controlled Trial | en |
dc.subject | Prospective Studies | en |
dc.title | A Randomized controlled trial of fresh frozen plasma for coagulopathy in Russell's viper (Daboia russelii) envenoming | en_US |
dc.type | Article | en_US |
Appears in Collections: | Journal/Magazine Articles |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
J Thromb Haemost_2017_15(4)_645.pdf | 390.1 kB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.