Intraarterial vs intravenous administration of antivenin for the treatment of Crotalidae atrox envenomation: A pilot study

Theodore C. Bania, Steven L. Bernstein, Bonny J. Baron, Daniel Rabinowitz

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: Standard therapy for significant snake envenomation includes antivenin. IV administration is currently the only recommended route. Intraarterial (IA) administration has potential advantages over IV that could improve outcome. To study this, the authors compared IV and IA antivenin administrations for the treatment of experimental snake envenomations. Methods: 14 adult female swine were anesthetized and prepared with femoral artery and ear vein catheters, and baseline hoof, forearm, and thigh circumference and volume displacement measurements were taken. Crotalidae atrox venom was injected into the subcutaneous tissue of the hoof. The doses of venom were 4.75, 9.50, 19.00, 37.90, 47.30, 56.90, and 66.40 mg. Immediately following injection of venom, polyvalent antivenin (Crotalidae) (0.285 mg/10 mL saline) was infused over 30 minutes into the femoral artery (IA group) or ear vein (IV group). As a control, 10 mL of saline was infused into the ear vein (IA group) or femoral artery (IV group). Measurements were recorded up to 48 hours. Linear mixed-effect regression models were used for each measurement and to compare the IA and IV groups. Results: Venom dose and time after administrations were associated with increased circumferences and increased volumes (p < 0.05). IV administration was associated with larger hoof (1.26 cm) and forearm (0.42 cm) sizes and volume displacement (21.71 mL) when compared with IA administration (p < 0.05). Conclusion: IA antivenin results in a modest but significant decrease in tissue edema when compared with IV.

Original languageEnglish
Pages (from-to)894-898
Number of pages5
JournalAcademic Emergency Medicine
Volume5
Issue number9
DOIs
StatePublished - Sep 1998
Externally publishedYes

Keywords

  • Antivenin
  • Crotalidae atrox
  • Intraarterial
  • Snake envenomation

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