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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Comparison of Different Dosing Protocols of Anti-Snake Venom (ASV) in Snake Bite Cases FC17-FC21
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Comparison of Different Dosing Protocols of Anti-Snake Venom (ASV) in Snake Bite Cases FC17-FC21

机译：蛇咬伤病例FC17-FC21中不同剂量的抗蛇毒（ASV）剂量比较

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Introduction: Considering the cost of Anti-Snake Venom (ASV) and irregularity in its supply, there is often a need to curtail doses of ASV, despite guidelines for management of snake bite. During June 2013 to Sept 2013, when ASV was in short supply, our institutional committee reviewed the overall hospital statistics of snake bite cases as well as scientific literature and formulated a working modified protocol that used low dose of ASV in snake bite cases. Aim: To retrospectively analyse and compare the modified ASV protocol versus conventional ASV protocol with respect to outcome, number of ASV vials required, duration of stay in the hospital/ ICU, and additional supportive interventions needed. Materials and Methods: This was a retrospective study conducted at a tertiary care teaching hospital, Maharashtra, India. Hospital records of inpatients admitted for snake bite during June 2013 to September 2013 (since introduction of the modified protocol) as well as during June 2012 to September 2012, (when patients received conventional protocol-historical controls) were retrospectively analysed to assess the number of ASV vials received by the patients during the stay, need for supportive therapy, duration of stay and outcome of the patients. Results: There was a significant reduction in average number of ASV vials per patient, required vide the modified protocol compared to their historical controls (10.74+0.95 Vs 28.17+2.75 p<0.001). There was no significant difference in outcome, need for dialysis, fresh frozen plasma requirement, need for ICU stay and duration of hospitalization of snake bite patients. Yet, the average cost of management of each patient reduced by approximately 11974.41 INR per treated patient, based on the requirement of ASV. Conclusion: The modified ASV protocol used in this study is more cost effective as compared to the conventional protocol, deserves prospective evaluation and may be followed at least during prime time of scarcity of ASV.
机译：简介：考虑到抗蛇毒（ASV）的成本及其供应的不规律性，尽管有蛇咬的管理指南，但通常仍需要减少ASV的剂量。在2013年6月至2013年9月期间，ASV供不应求，我们的机构委员会审查了蛇咬病例的整体医院统计数据以及科学文献，并制定了一种有效的改良方案，在蛇咬病例中使用了低剂量的ASV。目的：回顾性分析和比较改良的ASV方案与常规ASV方案的结局，所需的ASV小瓶数量，住院时间/住院时间以及所需的其他支持性干预措施。材料和方法：这是一项在印度马哈拉施特拉邦的三级护理教学医院进行的回顾性研究。回顾性分析2013年6月至2013年9月（自引入改进方案以来）以及2012年6月至2012年9月（当患者接受常规方案-历史对照时）因蛇咬伤入院的住院记录，以评估该病的数量。住院期间患者收到的ASV小瓶，需要支持治疗，住院时间和患者预后。结果：与他们的历史对照相比，修改后的方案所需的每位患者ASV小瓶的平均数量显着减少（10.74 + 0.95 Vs 28.17 + 2.75 p <0.001）。结局，透析需求，新鲜冷冻血浆需求，ICU停留需求和蛇咬伤患者住院时间之间无显着差异。但是，根据ASV的要求，每位患者的平均管理成本降低了约11974.41 INR。结论：与常规协议相比，本研究中使用的改良ASV协议更具成本效益，值得进行前瞻性评估，并且至少在ASV稀缺的黄金时段可以遵循。

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