Yılan ve Akrep Sokmalarında Nötrofil/Lenfosit Oranı ve Ortalama Trombosit Hacminin Antivenom Kullanımına Etkisi

Abstract

Amaç: Çocuk yoğun bakım ünitesinde (ÇYBÜ) yılan ve akrep sokmasıyla takip edilen hastalarda NLR VE MPV değerlerinin antivenom kullanımına etkisini ve bu değerlerin yoğun bakım ünitesi ve hastanede kalış sürelerine etkisini değerlendirmek amaçlandı. Gereç ve Yöntem: Yoğun bakım ünitesinde izlenen hastaların demografik özellikleri ve başvuru anındaki klinik bulgularının şiddeti, yılan ve akrep sokması sonrası antivenom kullanımı, hastane otomasyon sistemindeki klinik seyir ve arşivlenen dosya kayıtlarından retrospektif olarak incelendi. Bulgular: ÇYBÜ’de yılan ve akrep sokması nedeniyle izlenen 38 hastanın yarısı yılan, yarısı akrep sokması nedeniyle takibe alındı. Klinik evreye göre antivenom tedavisi uygulandı. Antivenom uygulanan hastalar ile NLR arasında pozitif korelasyon saptandı (p<0,05). Yılan sokması ve akrep sokması ayrı ayrı incelendiğinde antivenom uygulaması ile NLR arasında yılan sokmasında pozitif korelasyon bulunurken (p<0,05), akrep sokmasında ise herhangi bir korelasyon bulunmadı (p>0,05). Sonuç: Sonuç olarak yılan sokması ve akrep sokmalarında ana tedavi antivenom tedavisidir. Özellikle yılan sokmalarında hastalara panzehir uygulama kararı vermede NLR değerinin önemli olacağını düşünüyoruz. Ayrıca NLR değeri yüksek olanların kompartıman gelişimi açısından yakından izlenmesi gerekir.

Keywords

• Çocuk yoğun bakım
• Yılan ve akrep ısırığı
• Nötrofil lenfosit oranı
• Antivenom uygulaması

The Effect of Neutrophil/Lymphocyte Ratio and Mean Platelet Volume on the use of Antivenom in Snake Bites and Scorpion Stings

Abstract

Objective: We evaluated the distribution, use of antivenom, treatments applied during the follow-ups, and effects on the use of NLR and MPV antivenom in cases of snake bites and scorpion stings followed in the paediatric intensive care unit (PICU) and the effects of these cases on the length of stay in the intensive care unit and hospital. Materials and Methods: Demographic characteristics of the patients followed in the PICU and the severity of their clinical findings at admission, antivenom use after snake and scorpion bites were retrospectively examined from the clinical course in the hospital automation system and archived file records. Results: Of 38 patients who were followed up in the PICU for snake and scorpion bites, half were followed up for snake bites and half for scorpion bites. Antivenom treatment was applied according to the clinical stage. There was a positive correlation between antivenom-administered patients and NLR (p<0,05). When snake bites and scorpion stings were examined separately, there was a positive correlation between antivenom application and NLR in snake bites (p<0.05), but no correlation was found in scorpion stings (p>0.05). Conclusion: Consequently, antivenom therapy is the main treatment for snake bites and scorpion stings. We think that the NLR value will be significant in deciding to apply antivenom to patients, especially in snake bites. In addition, those with high NLR values need to be closely observed in terms of compartment development.

Keywords

• Paediatric intensive care
• snake and scorpion bite
• neutrophil/lymphocyte ratio
• antivenom administration

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