Acute and Critical Care

Corrigendum

Trauma
Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study: Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin; Acute Crit Care. 2020;35(1):56-56. Published online February 29, 2020; DOI: https://doi.org/10.4266/acc.2019.00591.e1; Corrects: Acute Crit Care 2019;34(4):269

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Original Articles

Trauma
Risk factor, monitoring, and treatment for snakebite induced coagulopathy: a multicenter retrospective study: Yong Jun Jeon, Jong Wan Kim, SungGil Park, Dong Woo Shin; Acute Crit Care. 2019;34(4):269-275. Published online November 18, 2019; DOI: https://doi.org/10.4266/acc.2019.00591; Correction in: Acute Crit Care 2020;35(1):56

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Background
Snakebite can cause various complications, including coagulopathy. The clinical features of snakebite-associated coagulopathy differ from those of disseminated intravascular coagulation (DIC) caused by other diseases and its treatment is controversial.
Methods
We retrospectively reviewed the medical records of patients hospitalized for snakebite between January 2006 and September 2018.
Results
A total of 226 patients were hospitalized due to snakebite. Their median hospital stay was 4.0 days (interquartile range, 2.0 to 7.0 days). Five patients arrived at hospital with shock and one patient died. Twenty-one patients had overt DIC according to the International Society of Thrombosis and Hemostasis scoring system. Two patients developed major bleeding complications. Initial lower cholesterol level at presentation was associated with the development of overt DIC. International normalization ratio (INR) exceeding the laboratory’s measurement limit was recorded as late as 4 to 5 days after the bite. Higher antivenom doses (≥18,000 units) and transfusion of fresh frozen plasma (FFP) or cryoprecipitate did not affect prolonged INR duration or hospital stay in the overt DIC patients without bleeding.
Conclusions
Initial lower cholesterol level may be a risk factor for overt DIC following snakebite. Although patients lack apparent symptoms, the risk of coagulopathy should be assessed for at least 4 to 5 days following snakebite. Higher antivenom doses and transfusion of FFP or cryoprecipitate may be unbeneficial for coagulopathic patients without bleeding.

Citations

Citations to this article as recorded by

A simple mortality risk prediction score for viper envenoming in India (VENOMS): A model development and validation study
Maya Gopalakrishnan, Suman Saurabh, Pramod Sagar, Chanaveerappa Bammigatti, Tarun Kumar Dutta, Nicholas R. Casewell
PLOS Neglected Tropical Diseases.2022; 16(2): e0010183. CrossRef
Attempt for a Recombinant Thrombomodulin Alpha Treatment in a Rat Disseminated Intravascular Coagulation Model Using Yamakagashi (Rhabdophis tigrinus) Venom
Akihiko Yamamoto, Takashi Ito, Toru Hifumi
Toxins.2022; 14(5): 322. CrossRef
Coagulopathy following Crotaliπae snakebites in northeast Florida
Satish Maharaj, Karan Seegobin, Simone Chang
Blood Coagulation & Fibrinolysis.2022; 33(4): 220. CrossRef
Unmasking the ties of snake bite poisoning and COVID-19
Anjuman Chander, Tanvir Samra, Sekar Loganathan, Varun Mahajan
Ain-Shams Journal of Anesthesiology.2022;[Epub] CrossRef
Venom induced consumption coagulopathy and performance of 20-min whole blood clotting test for its detection in viperid envenomation
Bayye Rajkumar, Kolar Vishwanath Vinod, Rakhee Kar, Premkumar Ramasubramani
Journal of the Royal College of Physicians of Edinburgh.2022; 52(3): 232. CrossRef
The effect of myocardial injury on the clinical course of snake envenomation in South Korea
J. M. Moon, Y. J. Koo, B. J. Chun, K. H. Park, Y. S. Cho, J. C. Kim, S. D. Lee, Y. R. Min, H. S. Park
Clinical Toxicology.2021; 59(4): 286. CrossRef

Infection
Experience with Elizabethkingia meningoseptica Infection in Adult Patients at a Tertiary Hospital: Hyun Don Joo, Sun Young Ann, Sung Hyeok Ryou, Youn Seup Kim, Jong Wan Kim, Doh Hyung Kim; Korean J Crit Care Med. 2015;30(4):241-248. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.241

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Abstract PDF

Background
Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection.
Methods
Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed.
Results
E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics.
Conclusions
E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.

Citations

Citations to this article as recorded by

Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma
Abha Sharma, Shweta Gupta, Tanisha Bharara, Shalini Dewan Duggal, Pragnya Paramita Jena, Renu Gur
The Indian Journal of Chest Diseases and Allied Sciences.2022; 61(2): 91. CrossRef

The Study of Rescuer's Fatigue by Changes of Compression-Vetilation Ratio using Manikin Model of the One-Rescuer CPR: Hee Bum Yang, Young Mo Yang, Jong Wan Kim, Won Young Sung, Ho Lee, Jang Young Lee, Sung Youp Hong; Korean J Crit Care Med. 2006;21(2):116-125.

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Abstract PDF: BACKGROUND
The point of this study is focused on the rescuer's fatigue may increase as the ratio of chest compression-ventilation increases.
METHODS
10 students of emergency medical service and resucue had participated in this study. Cardiopulmonary resuscitation (CPR) was carried out with Laerdal's ResusciAnne with 4 types of compression-ventilation ratio (C-V ratio), and the data was recorded. The rescuer's fatigue was subjectively estimated with the visual analogue scale (VAS), objective fatigue was measured by median frequency which was acquired from the electromyography (EMG) signal, heart rate and the serum lactate level was measured. Statistical analysis was accomplished within each C-V ratios.
RESULTS
As C-V ratio increased from 15 : 2 to 30 : 2, the quality of chest compression was improved. Subjective fatigue was increased significantly when C-V ratio increased to 30 : 2 from 15 : 2 and to 60 : 2 from 45 : 2. Gradual downward transition of the median frequency on EMG was shown as a result of increments of C-V ratio. Significant serum lactate accumulation had shown on ratio of 60 : 2 compare to other ratios.
CONCLUSIONS
Fatigue of the rescuers will be aggravated by increase of C-V ratio. Rapid rescuer change is preferable when C-V ratio is increased.

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