A randomized controlled trial of fresh frozen plasma for coagulopathy in Russell's viper (Daboia russelii) envenoming.

摘要: Background Russell's viper (Daboia russelii) envenoming is a major health issue in South Asia and causes venom induced consumption coagulopathy (VICC). Objectives We investigated the effect of fresh frozen plasma (FFP) two antivenom doses correcting VICC. Methods We undertook an open-label randomized controlled trial patients with VICC at Sri Lankan hospitals. Patients suspected Russell's bites were randomly allocated (1:1) high-dose (20 vials) or low-dose (10 plus 4U FFP. The primary outcome was proportion international normalized ratio (INR)<2, 6h post-antivenom. Secondary outcomes included anaphylaxis, haemorrhage, death clotting factor recovery. Results From 214 eligible patients, 141 randomized; 71 to antivenom, 70 antivenom/FFP; five had no post-antivenom bloods. groups similar except for delay 1h administration FFP patients. 23/69 (33%) INR<2 compared 28/67 (42%) antivenom/FFP [absolute difference 8%;95%Confidence Interval:-8% 25%]. 15 did not receive it. Severe anaphylaxis occurred equally frequently each group. One patient given developed transfusion related acute lung injury. Three deaths low-dose/FFP including one intracranial haemorrhage. There recovery rates INR fibrinogen, but more rapid initial V X patients. Conclusion FFP didn't hasten coagulopathy. Low-dose worsen VICC, suggesting sufficient. This article protected by copyright. All rights reserved.