The use of antivenom serum, fresh frozen plasma, and platelet concentrate for management strategy of snakebite related coagulopathy: a case series

Abstract

Snakebite is a medical emergency. It can cause local and systemic effects in humans. Different venomous snakes produce different types of venom, which can cause a variety of symptoms and complications. The scarcity of anti-snake venom serum (SABU) in Indonesia encourages alternative administration strategies to patients, namely suboptimal doses or subdose.
 Three cases of adult patients with a history of snakebite and diagnosed with snakebite grade III were reported. The patient underwent initial antivenom therapy using suboptimal doses of anti-snake venom serum (SABU) due to the scarcity of SABU and fresh frozen plasma (FFP) and thrombocyte concentrate (TC) transfusions as well as initial emergency management and routine blood tests and coagulation function. Evaluation was done daily of clinical improvement and coagulation function.
 This case series proves that administration of suboptimal antivenom therapy, when combined with additional FFP and TC transfusions, coupled with appropriate supportive care and patient monitoring can result in good outcome in patients.
 Key words: Anti-snake Venom Serum; FFP; Snakebite; Thrombocyte Concentrate; Toxin
 Citation: Permana SA, Shalihin MM. The use of antivenom serum, fresh frozen plasma, and platelet concentrate for management strategy of snakebite related coagulopathy: a case series. Anaesth. pain intensive care 2023;27(6):750−756; DOI: 10.35975/apic.v27i6.2250
 Received: July 27, 2023; Revised: October 17, 2023; Accepted: October 17, 2023