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- W4213105903 abstract "The presence of capillary leak syndrome (CLS) carries a very bad prognosis in patients with snake envenomation. It has almost 100% mortality as per literature. Here we have studied the effects of early institution of Therapeutic plasma exchange (TPE) in improving the outcome of such patients. TPE can remove the important large molecular weight toxins which may be responsible for increasing capillary permeability. We also assessed the prognostic variables in capillary leak syndrome following snake bite. All patients admitted with Russell’s viper bite who developed features of capillary leak syndrome during January 2019 to January 2020 were enrolled in the study. All these patients were treated with injection methyl prednisolone, anti-snake venom(ASV) and blood components as per protocol. Whenever possible, patients were taken for TPE at the earliest irrespective of their kidney function. Once they developed oligoanuric renal failure they were taken for haemodialysis continuing TPE simultaneously. During the study period, we had 254 patients admitted with snakebite. Of this 92 were poisonous bites. 59 out of 92 developed acute kidney injury necessitating dialysis support. 22 out of 59 had features of capillary leak syndrome. Out of these 22 patients with capillary leak syndrome we could save 11 patients (P value 0.014). During the year 2018 to 2019 we had 24 patients with capillary leak syndrome and the mortality was 22 out of 24. The worst prognostic factors were younger <25 years (Fisher exact P = 0.16), capillary leak syndrome in first 12 hours of bite and a platelet count of <50000 (p =0.02). The major cause of death in these patients were acute respiratory distress syndrome and intracranial bleed. Features of capillary leak syndrome in patients following poisonous snake bite carries very bad prognosis. Early institution of therapeutic plasma exchange is beneficial in such patients. Early development of capillary leak syndrome in first 12 hours of snakebite and a very low platelet count of less than 50,000 carries the worst prognosis." @default.
- W4213105903 created "2022-02-24" @default.
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- W4213105903 date "2022-02-01" @default.
- W4213105903 modified "2023-09-26" @default.
- W4213105903 title "POS-157 ROLE OF EARLY INSTITUTION OF THERAPEUTIC PLASMA EXCHANGE IN PATIENTS WITH CAPILLARY LEAK SYNDROME FOLLOWING SNAKE ENVENOMATION" @default.
- W4213105903 doi "https://doi.org/10.1016/j.ekir.2022.01.170" @default.
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