title: A localizing circumferential compression device delayed death after artificial eastern diamondback rattlesnake envenomation to the torso of an animal model in a pilot study.
abstract: Nearly all prior studies to delay onset of systemic toxicity and death after snake bite use a model of distal extremity envenomation. In the first of a series of planned studies using snake venoms with different toxicity profiles, the application of a novel device in a new model of torso envenomation in the setting of Eastern Coral Snake (Micrurus fulvius) venom (a potent neurotoxin) envenomation showed promise by delaying systemic intoxication. In this pilot study, we investigated this novel localizing circumferential compression (LoCC) device's ability to delay onset of life threatening systemic toxicity after Eastern Diamondback Rattlesnake (Crotalus adamanteus) envenomation, a potent hemotoxic and myotoxic venom. With university approval, four juvenile female pigs (22-25 kg) were anesthetized, sedated, and intubated but not paralyzed to allow for spontaneous respirations. Each animal was injected subcutaneously with 50 mg of C. adamanteus venom in identical preselected areas of the trunk. After 1 min, two treatment animals had the LoCC device applied; two control animals had no intervention. Vital signs were recorded every 10 min for the first 2 h and every 30 min thereafter. Endpoints included cardiovascular collapse (fatal arrhythmia, loss of mean arterial pressure, or pulse) or respiratory arrest (<3 breaths/min, saturation < 80%) or survival to 7 h. The pigs in the treatment group reached an endpoint at an average time of 355 (+/-65) min compared with control 32 (+/-3.5) min (p < 0.04). In this pilot study, the LoCC device significantly delayed onset of systemic symptoms and death after torso envenomation with Eastern Diamondback Rattlesnake venom in this model.
authors.affiliation: Department of Emergency Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA. jhack@lifespan.org
authors.forename: Jason B
authors.initials: JB
authors.lastname: Hack
authors.forename: Babatunde
authors.initials: B
authors.lastname: Orogbemi
authors.forename: Jocelyn M
authors.initials: JM
authors.lastname: Deguzman
authors.forename: Kori L
authors.initials: KL
authors.lastname: Brewer
authors.forename: William J
authors.initials: WJ
authors.lastname: Meggs
authors.forename: Dorcas
authors.initials: D
authors.lastname: O'Rourke
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D003435:Crotalid Venoms / Q000506:poisoning*; D017839:Crotalus; D004864:Equipment and Supplies; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced / Q000517:prevention & control; D006339:Heart Rate / Q000187:drug effects; D010865:Pilot Projects; D011312:Pressure; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000517:prevention & control; D012909:Snake Bites / Q000628:therapy*; D016019:Survival Analysis; D013552:Swine
chemical_list: D003435:Crotalid Venoms