Analysis of hemocoagulation tests for prediction of venom-induced consumption coagulopathy development after Viperidae bite
Abstract
OBJECTIVE: Viperidae snakes are responsible for 95 % of the bites caused by exotic-bred snakes in our country. Their envenoming may be associated with a severe acute coagulation disorder - venom-induced consumption coagulopathy (VICC).
Thus, its early prediction is vital for an adequate therapy including antivenom delivery. MATERIAL AND METHODS: Laboratory coagulation tests of 14 patients suffering from VICC were processed and statistically analyzed to evaluate the importance of individual parameters in the time after the bite.
RESULTS: The pathological values of D-dimer (D-dim) and fibrinogen (FBG) were found to be the first indicators of VICC development, with a median time of 4.55 hours since the bite, while median values for prothrombin time and international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), and thrombin time (TT) were 5.9 h, 8.15 h, and 5.5 h, respectively. In the first samples, the values of D-dim were found to be pathologically increased in all 14 patients, while pathological levels of FBG were seen only in 11 cases.
PT/INR and APTT were prolonged in 8 and 6 cases, respectively. CONCLUSION: An increase in D-dim values was found to be the first parameter signaling developing VICC in all analyzed cases.