The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study
Abstract Background Hump-nosed vipers (HNV; Hypnale spp) are one of the medically important venomous snakes in Sri Lanka and South-Western regions of India. The haemostatic dysfunction due to HNV bites is poorly characterized by standard diagnostic tests performed to identify coagulopathy. We aimed...
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ftdoajarticles:oai:doaj.org/article:c48eaa8daeab4fb3895dee5a0e0a504a 2023-05-15T15:10:36+02:00 The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study Bhawani Yasassri Alvitigala Lallindra Viranjan Gooneratne Iresha Dharmasena Nuwan Premawardana Manujasri Wimalachandra Miyuru Weerarathna Roopen Arya Ariaranee Gnanathasan 2023-01-01T00:00:00Z https://doi.org/10.1186/s40794-022-00186-2 https://doaj.org/article/c48eaa8daeab4fb3895dee5a0e0a504a EN eng BMC https://doi.org/10.1186/s40794-022-00186-2 https://doaj.org/toc/2055-0936 doi:10.1186/s40794-022-00186-2 2055-0936 https://doaj.org/article/c48eaa8daeab4fb3895dee5a0e0a504a Tropical Diseases, Travel Medicine and Vaccines, Vol 8, Iss 1, Pp 1-7 (2023) Coagulopathy Hump-nosed viper Rotational thromboelastometry WBCT20 Arctic medicine. Tropical medicine RC955-962 article 2023 ftdoajarticles https://doi.org/10.1186/s40794-022-00186-2 2023-01-15T01:29:42Z Abstract Background Hump-nosed vipers (HNV; Hypnale spp) are one of the medically important venomous snakes in Sri Lanka and South-Western regions of India. The haemostatic dysfunction due to HNV bites is poorly characterized by standard diagnostic tests performed to identify coagulopathy. We aimed to determine the usefulness of rotational thromboelastometry (ROTEM) parameters compared to 20-minute whole blood clotting test (WBCT20) and prothrombin time (PT) in understanding the coagulopathy of HNV bites. Methods Twenty-three HNV snakebite patients in a prospective study of 127 consecutive snakebites were recruited. After recording details of the clinical presentation, PT/international normalized ratio (INR), WBCT20 and ROTEM delta were performed at presentation. Results In this preliminary study, none of the patients had clinically apparent bleeding. Coagulopathy was detected by either WBCT20, INR or ROTEM in 13 HNV patients. Eleven had a coagulopathy detectable by ROTEM (either abnormal EXTEM-CT, INTEM-CT or FIBTEM-MCF) but with negative WBCT20. Of them, only two had prolonged INR values. Two patients had positive WBCT20 but with normal ROTEM and INR values. The remaining 10 patients did not show any coagulopathy either by INR, ROTEM or WBCT20. Conclusion In this preliminary study with small number of sample size, ROTEM parameters appeared to be more sensitive to subtle changes in coagulation compared to WBCT20. The clinical utility of detecting these changes and their usefulness in managing snakebite should be explored further in a larger study. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tropical Diseases, Travel Medicine and Vaccines 8 1 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Coagulopathy Hump-nosed viper Rotational thromboelastometry WBCT20 Arctic medicine. Tropical medicine RC955-962 |
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Coagulopathy Hump-nosed viper Rotational thromboelastometry WBCT20 Arctic medicine. Tropical medicine RC955-962 Bhawani Yasassri Alvitigala Lallindra Viranjan Gooneratne Iresha Dharmasena Nuwan Premawardana Manujasri Wimalachandra Miyuru Weerarathna Roopen Arya Ariaranee Gnanathasan The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
topic_facet |
Coagulopathy Hump-nosed viper Rotational thromboelastometry WBCT20 Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract Background Hump-nosed vipers (HNV; Hypnale spp) are one of the medically important venomous snakes in Sri Lanka and South-Western regions of India. The haemostatic dysfunction due to HNV bites is poorly characterized by standard diagnostic tests performed to identify coagulopathy. We aimed to determine the usefulness of rotational thromboelastometry (ROTEM) parameters compared to 20-minute whole blood clotting test (WBCT20) and prothrombin time (PT) in understanding the coagulopathy of HNV bites. Methods Twenty-three HNV snakebite patients in a prospective study of 127 consecutive snakebites were recruited. After recording details of the clinical presentation, PT/international normalized ratio (INR), WBCT20 and ROTEM delta were performed at presentation. Results In this preliminary study, none of the patients had clinically apparent bleeding. Coagulopathy was detected by either WBCT20, INR or ROTEM in 13 HNV patients. Eleven had a coagulopathy detectable by ROTEM (either abnormal EXTEM-CT, INTEM-CT or FIBTEM-MCF) but with negative WBCT20. Of them, only two had prolonged INR values. Two patients had positive WBCT20 but with normal ROTEM and INR values. The remaining 10 patients did not show any coagulopathy either by INR, ROTEM or WBCT20. Conclusion In this preliminary study with small number of sample size, ROTEM parameters appeared to be more sensitive to subtle changes in coagulation compared to WBCT20. The clinical utility of detecting these changes and their usefulness in managing snakebite should be explored further in a larger study. |
format |
Article in Journal/Newspaper |
author |
Bhawani Yasassri Alvitigala Lallindra Viranjan Gooneratne Iresha Dharmasena Nuwan Premawardana Manujasri Wimalachandra Miyuru Weerarathna Roopen Arya Ariaranee Gnanathasan |
author_facet |
Bhawani Yasassri Alvitigala Lallindra Viranjan Gooneratne Iresha Dharmasena Nuwan Premawardana Manujasri Wimalachandra Miyuru Weerarathna Roopen Arya Ariaranee Gnanathasan |
author_sort |
Bhawani Yasassri Alvitigala |
title |
The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
title_short |
The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
title_full |
The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
title_fullStr |
The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
title_full_unstemmed |
The use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (Hypnale spp) bites: a preliminary study |
title_sort |
use of rotational thromboelastometry parameters in understanding the coagulopathy following hump-nosed viper (hypnale spp) bites: a preliminary study |
publisher |
BMC |
publishDate |
2023 |
url |
https://doi.org/10.1186/s40794-022-00186-2 https://doaj.org/article/c48eaa8daeab4fb3895dee5a0e0a504a |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Diseases, Travel Medicine and Vaccines, Vol 8, Iss 1, Pp 1-7 (2023) |
op_relation |
https://doi.org/10.1186/s40794-022-00186-2 https://doaj.org/toc/2055-0936 doi:10.1186/s40794-022-00186-2 2055-0936 https://doaj.org/article/c48eaa8daeab4fb3895dee5a0e0a504a |
op_doi |
https://doi.org/10.1186/s40794-022-00186-2 |
container_title |
Tropical Diseases, Travel Medicine and Vaccines |
container_volume |
8 |
container_issue |
1 |
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1766341589889712128 |