title: Study of severe scorpion envenoming following subcutaneous venom injection into dogs: Hemodynamic and concentration/effect analysis.
abstract: To evaluate the dose-effects of Androctonus australis hector (Aah) venom injected subcutaneously on hemodynamics and neurohormonal secretions, 10 anesthetized and ventilated mongrel dogs, were split in two groups (n = 5/group). Subcutaneous injection was done with either 0.2 mg/kg or 0.125 mg/kg of the purified G50 scorpion toxic fraction. Hemodynamic parameters using right heart catheter were recorded and plasma concentrations of catecholamine, troponin, and serum toxic fraction were measured sequentially from baseline to 120 min. We identified the dose of toxic fraction evoking characteristic hemodynamic perturbation of severe envenomation, the time-lapse to envenomation, and the associated plasma level. The injection of 0.125 mg/kg toxic fraction was not associated with significant variations in hemodynamic parameters, whereas the 0.2 mg/kg dose caused envenomation characterized by significant increase in plasma catecholamines, increased pulmonary artery occluded pressure, mean arterial pressure, and systemic vascular resistance (p < 0.05), in association with sustained decline in cardiac output (p < 0.001). Envenomation occurred by the 30th minute, and the corresponding concentration of toxic fraction was 1.14 ng/ml. The current experiment allowed the identification of the sub-lethal dose (0.2 mg/kg) of the toxic fraction of Aah administered by the subcutaneous route. Two parameters with potential clinical relevance were also uncovered: the time-lapse to envenomation and the corresponding concentration of toxic fraction.
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia. Electronic address: Souheil.elatrous@rns.tn.
authors.forename: Souheil
authors.initials: S
authors.lastname: Elatrous
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Lamia
authors.initials: L
authors.lastname: Ouanes-Besbes
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia.
authors.forename: Habiba
authors.initials: H
authors.lastname: Ben Sik-Ali
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Zineb
authors.initials: Z
authors.lastname: Hamouda
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Saoussen
authors.initials: S
authors.lastname: BenAbdallah
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia.
authors.forename: Nejla
authors.initials: N
authors.lastname: Tilouche
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Faten
authors.initials: F
authors.lastname: Jalloul
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Tahar Sfar. Mahdia, University of Monastir, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fkih-Hassen
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Fahmi
authors.initials: F
authors.lastname: Dachraoui
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Islem
authors.initials: I
authors.lastname: Ouanes
authors.affiliation: Laboratoire de Recherche LR12-SP15 (Recherche Cardio - pulmonaire en médecine aigue et Toxicologie), Tunisia; ICU CHU Fatouma Bourguiba Monastir, University of Monastir, Tunisia.
authors.forename: Fekri
authors.initials: F
authors.lastname: Abroug
mesh_terms: D000818:Animals; D002395:Catecholamines / Q000097:blood; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D006439:Hemodynamics; D007279:Injections, Subcutaneous; D007928:Lethal Dose 50; D065008:Scorpion Stings / Q000097:blood / Q000473:pathology*; D012604:Scorpion Venoms / Q000097:blood / Q000633:toxicity*; D012605:Scorpions; D014336:Troponin / Q000097:blood
chemical_list: D002395:Catecholamines; D012604:Scorpion Venoms; D014336:Troponin
keywords: Androctonus australis hector; Animal study; Hemodynamic effects; Scorpion envenomation; Subcutaneous injection