Retrospective Analysis of the Demographic and Clinical Features of Snake Bites Followed in the Intensive Care Unit

Yıl 2022, Cilt: 17 Sayı: 3, 129 - 137, 02.11.2022

Onur Hanbeyoğlu , Aykut Urfalıoğlu , Tuğba Hünerel

https://doi.org/10.17517/ksutfd.1015725

Cited By: 1

Öz

Abstract

Objective: The cases of poisoning due to snake bite are a medical condition that requires an emergency treatment approach, which creates serious health problems that can be seen in our country and all over the world. In the Eastern Anatolia Region, poisoning cases due to the bites of viper snakes, especially from the Viperidae family, are frequently observed. The aim of this study is to examine the treatment modalities of patients treated in our intensive care unit

due to snake bites in and around the city of Elazig province and to present our clinical experience with snake bites.

Material and Methods: Our study included 44 patients who were treated in the anesthesia intensive care clinic with the complaint of snake bite between August 2018 and August 2021. Symptoms, bite sites, clinical stages, need and doses of antivenom, changes in blood biochemistry, length of hospital stay, prognostic characteristics and mortality of these patients exposed to snake bites were retrospectively analysed.

Results: A total of 44 patients, 13 female (29.55%) and 31 male (70.45%), aged between 18-72 years, who were followed up for snake bites, were included in the study. In our study, the severity of poisoning was determined and staging was performed according to the clinical symptoms and laboratory findings of the patients. The snake bites were observed in 1 (2.27%) patients in Stage 0, 18 (40.90%) in Stage 1, 21 (47.7%) in Stage 2, and 4 (9.09%) patients in Stage 3. The patients included in our study were divided into two groups as Stage (0-1) and Stage (2-3) according to their stages, and the antivenom doses taken by these two groups were compared. While total antivenom (4.33±2.18) vials were given to 10 poisoning cases with stage (0-1), total antivenom (7.65±3.03) vials were administered to 25 poisoning cases with stage (2-3).

Conclusion: We believe that early and adequate dose of antivenom treatment in snake bite cases treated in intensive care units can prevent complications that may develop after poisoning and reduce mortality.

Anahtar Kelimeler

Snake bites, Antivenom, Snake envenomations

Yoğun Bakım Ünitesinde Takip Edilen Yılan Isırması Olgularının Demografik ve Klinik Özelliklerinin Retrospektif Analizi

Öz

Özet

Amaç: Yılan ısırmasına bağlı zehirlenme olguları, ülkemizde ve tüm dünyada görülebilen ciddi sağlık problemleri oluşturan acil tedavi yaklaşımı gerektiren bir tıbbi durumdur. Doğu Anadolu Bölgesi’nde, özellikle Viperidae ailesinden olan engerek yılanlarının ısırmalarına bağlı zehirlenme vakaları sıklıkla görülmektedir. Bu çalışmadaki amaç, Elazığ ili ve çevresinde yılan ısırması nedeniyle yoğun bakım ünitemizde tedavi gören hastaların tedavi modalitelerini incelemek ve yılan ısırması ile ilgili klinik deneyimlerimizi sunmaktır.

Gereç ve Yöntemler: Çalışmamıza Ağustos 2018 ile Ağustos 2021 tarihleri arasında yılan ısırması şikayeti ile yoğun bakım kliniğinde tedavi gören 44 hasta dâhil edildi. Yılan ısırığına maruz kalan bu hastaların semptomları, ısırılan bölgeleri, klinik evreleri, antivenom ihtiyacı ve dozları, kan biyokimyasındaki değişiklikler, hastanede kalış süreleri, prognoz karakteristikleri ve mortaliteleri retrospektif olarak incelendi.

Bulgular: Yılan sokması nedeniyle takip edilen 18-72 yaşları arasında 13 kadın (%29.55) ve 31 erkek (%70.45) olmak üzere toplam 44 hasta çalışmaya dâhil edildi. Çalışmamızda, hastalar klinik semptomlarına ve laboratuvar bulgularına göre zehirlenme şiddeti belirlenerek evrelendirme yapıldı. Evre 0’da 1 (%2.27), Evre 1’de 18 (%40.90), Evre 2’de 21 (%47.7) ve Evre 3’te 4 (%9.09) hastanın yılan ısırması nedeniyle takip edildiği saptandı. Çalışmamıza dâhil edilen hastalar, evrelerine göre Evre (0-1) ve Evre (2-3) olarak iki gruba ayrılarak bu iki grubun aldıkları antivenom dozları karşılaştırıldı. Evre (0-1) olan 10 zehirlenme olgusuna total antivenom (4.33±2.18) vial verilirken, Evre (2-3) olan 25 zehirlenme olgusuna total antivenom (7.65±3.03) vial uygulandı.

Sonuç: Yoğun bakım ünitelerinde tedavi gören yılan ısırması olgularına erken ve yeterli dozda uygulanan antivenom tedavisinin, zehirlenme sonrası gelişebilecek komplikasyonları engelleyebileceği ve mortaliteyi azaltacağı görüşündeyiz.

Anahtar Kelimeler

Yılan ısırıkları, Antivenom, yılan zehirlenmeleri

Kaynakça

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