title: Severe Snakebite Envenoming in Intensive Care.
abstract: Snakebites by exotic venomous snakes can cause serious or even life-threatening envenoming. In Europe and North America most victims are breeders, with a few snakebites from wild native American rattlesnakes. The envenomed victims may present in organ and/or system failure with muscle paralysis, respiratory failure, circulatory instability, acute kidney injury, severe coagulation disorder, and local disability - compartment syndrome and necrosis. Best managed by close collaboration between clinical toxicology and intensive care, most severe envenomings are managed primarily by intensive care physicians. Due to the low incidence of severe envenoming, the clinical course and correct management of these cases are not intrinsically familiar to most physicians. This review article summarizes the clinical syndromes caused by severe envenoming and the therapeutic options available in the intensive care setting.
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic. jiri.valenta@vfn.cz.
authors.forename: Jiří
authors.initials: J
authors.lastname: Valenta
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Stach
authors.affiliation: Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Michálek
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D010808:Physical Examination; D012909:Snake Bites / Q000175:diagnosis* / Q000188:drug therapy*; D012910:Snake Venoms / Q000506:poisoning*; D012911:Snakes
chemical_list: D000997:Antivenins; D012910:Snake Venoms
keywords: Coagulopathy; Compartment syndrome; Envenoming; Exotic snakes; Intensive care; Organ failure; Snakebite; Treatment