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Tedavide kullanılan iki tip polivalan yılan antivenomunun karşılaştırılması

Year 2020, Volume: 45 Issue: 3, 1230 - 1237, 30.09.2020
https://doi.org/10.17826/cumj.737922

Abstract

Amaç: Bu çalışmada; acil servise yılan ısırması ile başvuran hastalarda kullanılan iki tip polivalan yılan antivenomun etkinliğinin karşılaştırılması ve olası lokal ve sistemik yan etkilerin belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışmaya yılan ısırması şikayeti olan 30 hasta dahil edildi. Hastalar aldıkları antivenom tipine (PoliseraTM veya PolivalanTM) göre gruplandırıldı. Hastaların demografik özelliklerinin yanı sıra, vital bulguları, lokal doku bulguları ve laboratuvar parametreleri standart veri formuna kaydedildi. Her grupta kaç vial yılan anti serumu kullanıldığı, kaç kez ek doz venom ihtiyacı olduğu; antivenoma karşı herhangi bir reaksiyon gelişip gelişmediği kaydedildi.
Bulgular: Çalışmaya 30 hasta dahil edildi. 16 hastaya Polisera TM (Grup 1) yılan antivenomu, 14 hastaya PolivalanTM (Grup 2) yılan antivenomu verildi. Grup 1'deki hastalara ortalama 9.1±7.3 vial antivenom verilirken, Grup 2'deki hastalara ortalama 11.6±12.7 vial verildi. PolivalanTM antivenom alan grupta daha fazla alerjik reaksiyon-ürtiker, ateş ve selülitgözlendi.
Sonuç: Pirojen kontaminasyonu, üretimden kaynaklanan farklı metodolojiler ve ambalaj farklılıkları aynı doz ve içeriğe sahip antivenom ürünlerinde bile farklı etkilere ve yan etkilere neden olabilir.

References

  • Bilir Ö. Sürüngenler. Klinik Toksikoloji Tanı ve Tedavi. (Editörler: Satar S, Yürümez Y, Güneysel Ö, Türedi S, Akıcı A) 1. Baskı, Antalya, Çukurova Nobel Tıp Kitabevi, 2020, p: 1011-1018. ISBN: 978-605-2369-22-7.
  • Warrell DA, Venomous Bites, Stings, and Poisoning: An Update. Infect Dis Clin N Am. 2019; 33:17–38
  • Aslan N, Yıldızdaş D, Horoz ÖÖ, Ekinci F, Arslan D, Bilen S ,Yilmaz HL. The relationship between neutrophil lymphocyte ratio and clinical outcomes after snakebite in pediatric patients. Cukurova Medical Journal 44 (2019 ): 1040-1045
  • Okur Mİ, Yıldırım AM, Köse R. Türkiye’de Zehirli Yılan Isırmaları ve Tedavisi. Türkiye Klinikleri Tıp bilimleri Dergisi 2001; 21:21-4.
  • Kara ME, Ay MO, Seğmen S, Avcı A, İçme F, Gökel Y. Management of snake bites. Archives Medical Review Journal. 2014;23:272–92.
  • David Warrell. Snakebites. World Health Organization, Guidelines for the management of snakebites. 2nd Edition. WHO/Regional Office for South-East Asia. August 2016 140 p. ISBN 978 92 9022 530 0.
  • Altun D, Altun D, Ayaz B. Our Clinical Experiences in Snake Bites. J Turk Soc Intens Care 2016;14:100-4.
  • Gümüştekin M, Sarıçoban B, Gürkan MA. Antivenoms and principles of application. J DEU Med 2019;34(1):73-83.
  • Product information of Polisera Vial Containing Injectable Solution Against Snakebites. Date of access: 10.05.2020 Access web address: http://www.vetalserum.com.tr/panel/images/dosyalar/poliserakub.pdf
  • Scharman EJ, Noffsinger VD. Copperhead snakebites: Clinical severity of local effects. Ann Emerg Med. 2001;38:55-61.
  • Isbister GK. Antivenom efficacy or effectiveness: The Australian experience. Toxicology. 2010; 268: 148–54.
  • León, G., Vargas, Mariá., Segura, Á., Herrera, Marí., Villalta, M., Sánchez, André., Solano, G., Gómez, Aaró., Sánchez, M., Estrada, R., Gutiérrez, José.Marí. Current technology for the industrial manufacture of snake antivenoms, Toxicon. 2018;151:63-73
  • Roberts JR, Otten EJ. Snakebites and other reptiles. In: Goldfrank LR, editor. Goldfrank's toxicologic emergencies. Stamford (Conn): Appleton & Lange; 1998. p. 1603-23.
  • Açikalin A, Gökel Y, Kuvandik G, Duru M, Köseoğlu Z, Satar S. The efficacy of low-dose antivenom therapy on morbidity and mortality in snakebite cases. Am J Emerg Med. 2008 May;26(4):402-7.
  • Sarin K, Dutta KT, Vinod KV. Clinical profile & complications of neurotoxic snake bite & comparison of two regimens of polyvalent anti-snake venom in its treatment. Indian J Med Res, 2017;145:58-62.

Comparison of two types of polyvalent snake antivenom used in treatment

Year 2020, Volume: 45 Issue: 3, 1230 - 1237, 30.09.2020
https://doi.org/10.17826/cumj.737922

Abstract

Purpose: In this study; we aimed to compare the effectiveness of the two types of polyvalent snake antivenom and to determine the possible local and systemic reactions in patients who admitted to the emergency department with snake bite.
Materials and Methods: We performed this retrospective study on 30 patients who complained of snakebite. We grouped the patients according to the antivenom type (PoliseraTM or Polivalan TM) which they received. Demographic characteristics of the patients, vital signs, local tissue findings, and laboratory parameters were recorded in the standard data form. The following data were also recorded; the number of vials of snake antivenom used in each group, additional doses of venom were administered, and whether any local or systemic reaction to antivenom has developed or not.
Results: Thirty patients were included in the study. 16 patients were administered PoliseraTM (Group 1) snake antivenom and 14 patients were administered Polivalan TM (Group 2) snake antivenom. Patients in Group 1 were given an average of 9.1±7.3 vials, while patients in Group 2 were given an average of 11.6±12.7 vials. More allergic reactions-urticaria, fever, and cellulite were observed in the group receiving PolivalanTM antivenom.
Conclusion: Different methodologies arising from the production of antivenom, pyrogen contamination, and differences in packaging can cause different effects and side effects even in products with the same dose and antivenom content.

References

  • Bilir Ö. Sürüngenler. Klinik Toksikoloji Tanı ve Tedavi. (Editörler: Satar S, Yürümez Y, Güneysel Ö, Türedi S, Akıcı A) 1. Baskı, Antalya, Çukurova Nobel Tıp Kitabevi, 2020, p: 1011-1018. ISBN: 978-605-2369-22-7.
  • Warrell DA, Venomous Bites, Stings, and Poisoning: An Update. Infect Dis Clin N Am. 2019; 33:17–38
  • Aslan N, Yıldızdaş D, Horoz ÖÖ, Ekinci F, Arslan D, Bilen S ,Yilmaz HL. The relationship between neutrophil lymphocyte ratio and clinical outcomes after snakebite in pediatric patients. Cukurova Medical Journal 44 (2019 ): 1040-1045
  • Okur Mİ, Yıldırım AM, Köse R. Türkiye’de Zehirli Yılan Isırmaları ve Tedavisi. Türkiye Klinikleri Tıp bilimleri Dergisi 2001; 21:21-4.
  • Kara ME, Ay MO, Seğmen S, Avcı A, İçme F, Gökel Y. Management of snake bites. Archives Medical Review Journal. 2014;23:272–92.
  • David Warrell. Snakebites. World Health Organization, Guidelines for the management of snakebites. 2nd Edition. WHO/Regional Office for South-East Asia. August 2016 140 p. ISBN 978 92 9022 530 0.
  • Altun D, Altun D, Ayaz B. Our Clinical Experiences in Snake Bites. J Turk Soc Intens Care 2016;14:100-4.
  • Gümüştekin M, Sarıçoban B, Gürkan MA. Antivenoms and principles of application. J DEU Med 2019;34(1):73-83.
  • Product information of Polisera Vial Containing Injectable Solution Against Snakebites. Date of access: 10.05.2020 Access web address: http://www.vetalserum.com.tr/panel/images/dosyalar/poliserakub.pdf
  • Scharman EJ, Noffsinger VD. Copperhead snakebites: Clinical severity of local effects. Ann Emerg Med. 2001;38:55-61.
  • Isbister GK. Antivenom efficacy or effectiveness: The Australian experience. Toxicology. 2010; 268: 148–54.
  • León, G., Vargas, Mariá., Segura, Á., Herrera, Marí., Villalta, M., Sánchez, André., Solano, G., Gómez, Aaró., Sánchez, M., Estrada, R., Gutiérrez, José.Marí. Current technology for the industrial manufacture of snake antivenoms, Toxicon. 2018;151:63-73
  • Roberts JR, Otten EJ. Snakebites and other reptiles. In: Goldfrank LR, editor. Goldfrank's toxicologic emergencies. Stamford (Conn): Appleton & Lange; 1998. p. 1603-23.
  • Açikalin A, Gökel Y, Kuvandik G, Duru M, Köseoğlu Z, Satar S. The efficacy of low-dose antivenom therapy on morbidity and mortality in snakebite cases. Am J Emerg Med. 2008 May;26(4):402-7.
  • Sarin K, Dutta KT, Vinod KV. Clinical profile & complications of neurotoxic snake bite & comparison of two regimens of polyvalent anti-snake venom in its treatment. Indian J Med Res, 2017;145:58-62.
There are 15 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Research
Authors

Müge Gülen 0000-0002-5080-3501

Salim Satar 0000-0001-6080-4287

Önder Yeşiloğlu This is me 0000-0003-0149-8456

Çağdaş İnce This is me 0000-0002-5914-1460

Cemre Esen This is me 0000-0001-8726-6925

Selen Acehan This is me 0000-0003-4390-6593

Publication Date September 30, 2020
Acceptance Date July 21, 2020
Published in Issue Year 2020 Volume: 45 Issue: 3

Cite

MLA Gülen, Müge et al. “Comparison of Two Types of Polyvalent Snake Antivenom Used in Treatment”. Cukurova Medical Journal, vol. 45, no. 3, 2020, pp. 1230-7, doi:10.17826/cumj.737922.