Neutralization, by a polyspecific antivenom, of the coagulopathy induced by the venom of Bothrops asper: Assessment by standard coagulation tests and rotational thromboelastometry in a murine model

Camacho, Erika; Ramírez-Vargas, Gabriel; Vargas, Karol; Rucavado, Alexandra; Escalante, Teresa; Vargas, Mariángela; Segura, Álvaro; Argüello, Ivette; Campos, Marlen; Guerrero, German; Méndez, Marilla Lamela; Gutiérrez, José María

doi:10.1016/j.toxicon.2023.107301

Toxicon

2023

DOI: 10.1016/j.toxicon.2023.107301

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Neutralization, by a polyspecific antivenom, of the coagulopathy induced by the venom of Bothrops asper: Assessment by standard coagulation tests and rotational thromboelastometry in a murine model

Erika Camacho,

Gabriel Ramírez-Vargas,

Karol Vargas

et al.

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2024

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

Abouyannis,

Marriott,

Stars

et al. 2024

Thromb Haemost

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Venom induced consumption coagulopathy (VICC) is a common complication of snakebite that is associated with hypofibrinogenaemia, bleeding, disability, and death. In remote tropical settings, where most snakebites occur, the 20-minute whole blood clotting test is used to diagnose VICC. Point-of-care (POC) coagulation devices could provide an accessible means of detecting VICC that is better standardised, quantifiable, and more accurate. In this scoping review, the mechanistic reasons that previously studied POC devices have failed in VICC are considered, and evidence-based recommendations are made to prioritise certain devices for clinical validation studies. Four small studies have evaluated a POC international normalised ratio (INR) device in patients with Australian Elapid, Daboia russelii and Echis carinatus envenoming. All of these studies used POC INR devices that rely on a thrombin substrate endpoint, which, unlike laboratory-based INR measurement, is known to underestimate INR in patients with hypofibrinogenaemia. Seventeen commercially available POC devices for measuring INR, activated clotting time (ACT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, and fibrin(ogen) degradation products (FDP) have been reviewed. POC INR devices that detect fibrin clot formation, as well as a novel POC device that quantifies fibrinogen were identified, that show promise for use in patients with VICC. These devices could support more accurate allocation of antivenom, reduce the time to antivenom administration, and provide improved clinical trial outcome measurement instruments. There is an urgent need for these promising POC coagulation devices to be validated in prospective clinical snakebite studies.

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

Abouyannis,

Marriott,

Stars

et al. 2024

Thromb Haemost

View full text Add to dashboard Cite

show abstract

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Neutralization, by a polyspecific antivenom, of the coagulopathy induced by the venom of Bothrops asper: Assessment by standard coagulation tests and rotational thromboelastometry in a murine model

Cited by 1 publication

References 39 publications

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

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

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