Snake venoms and coagulopathy

摘要

Snakebite affects around 2.5 million humans annually, with greater than 100,000 deaths. Coagulopathy is a significant cause of both morbidity and mortality in these patients, either directly, or indirectly. This paper reviews clinical aspects of snakebite coagulopathy, including types of coagulopathy (procoagulant, fibrinogen clotting, fibrinolytic, platelet-active, anticoagulant, thrombotic, haemorrhagic), diagnosis and treatment. Examples of clinical laboratory findings in selected types of snakebite coagulopathy are presented. Where available, antivenom is the most effective treatment, while standard treatments for other forms of coagulopathy, such as factor replacement therapy and heparin, are either ineffective or dangerous in snakebite coagulopathy, except in specific situations. (c) 2005 S. Yamamoto. Published by Elsevier Ltd. All rights reserved.