Table 2.
Estimation of snake venom PLA2 and envenomation complications before and after ASV administration
| Patient no | Envenomation complications | Before ASV | 24 hr after ASV |
|---|---|---|---|
| 1 | PLA2 | 1.09 ± 0.04 | 0.64 ± 0.09*** |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 seconds, platelets: 50–100 K/mL, fibrinogen: 50–100 µg/mL | No signs/symptoms | |
| 2 | PLA2 | 0.88 ± 0.10 | 0.67 ± 0.17** |
| Pulmonary system | Moderate respiratory distress, 26–40 bpm | No signs/symptoms | |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 seconds, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| Central nervous system | Severe confusion, lethargy, seizures, coma, psychosis, or generalized fasciculation | Minimal apprehension, headache, weakness, dizziness, chills, or paresthesia | |
| 3 | PLA2 | 0.95 ± 0.03 | 0.57 ± 0.12*** |
| Local wound | No signs/symptoms | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 seconds, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 4 | PLA2 | 0.86 ± 0.07 | 0.74 ± 0.13 |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 5 | PLA2 | 1.08 ± 0.05 | 0.40 ± 0.3*** |
| Pulmonary system | Moderate respiratory distress, 26–40 bpm | Dyspnea, minimal chest tightness, mild/vague discomfort, and respirations of 20–25 bpm | |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters markedly abnormal, with serious bleeding or the threat of spontaneous bleeding; unmeasurable PT or PTT, platelets <20 K/mL, undetectable fibrinogen, severe abnormalities of other lab values also fall into this category | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | |
| Central nervous system | Minimal apprehension, headache, weakness, dizziness, chills, or paresthesia | No signs/symptoms | |
| 6 | PLA2 | 1.10 ± 0.16 | 0.67 ± 0.10*** |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | No signs/symptoms | |
| 7 | PLA2 | 0.92 ± 0.05 | 0.36 ± 0.08*** |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT<20 secs, PTT <50 secs, platelets 100–150 K/mL, or fibrinogen: 100–150µg/mL | No signs/symptoms | |
| 8 | PLA2 | 0.85 ± 0.08 | 0.42 ± 0.29*** |
| Pulmonary system | Moderate respiratory distress, 26–40 bpm | Dyspnea, minimal chest tightness, mild/vague discomfort, respirations of 20–25 bpm | |
| Cardiovascular system | HR: 100–125 BPM, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Central nervous system | Moderate apprehension, headache, weakness, dizziness, chills, paresthesia, confusion, or fasciculation in area of bite site | Minimal apprehension, headache, weakness, dizziness, chills, or paresthesia | |
| 9 | PLA2 | 0.58 ± 0.22 | 0.29 ± 0.06*** |
| Local wound | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | No signs/symptoms | |
| 10 | PLA2 | 1.05 ± 0.04 | 0.56 ± 0.05*** |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, or fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 11 | PLA2 | 0.85 ± 0.08 | 0.63 ± 0.10*** |
| Local wound | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | No signs/symptoms | |
| 12 | PLA2 | 0.78 ± 0.06 | 0.44 ± 0.28*** |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | Coagulation parameters slightly abnormal: PT<20 sec, PTT <50 sec, platelets: 100–150 K/mL, or fibrinogen: 100–150 µg/mL | |
| 13 | PLA2 | 1.16 ± 0.09 | 0.67 ± 0.05*** |
| Local wound | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | |
| Hematologic symptoms | Coagulation parameters markedly abnormal, with serious bleeding or the threat of spontaneous bleeding; unmeasurable PT/PTT, platelets <20 K/mL, undetectable fibrinogen, and severe abnormalities of other lab values also fall into this category | Coagulation parameters abnormal: PT <20–25 sec, PTT <50–75 sec, platelets: 50–100 K/mL, or fibrinogen: 50–100 µg/mL | |
| 14 | PLA2 | 0.46 ± 0.17 | 1.16 ± 0.10*** |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <50–100 sec, PTT <75–100 sec, platelets: 20–50 K/mL, or fibrinogen: <50 µg/mL | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | |
| 15 | PLA2 | 0.56 ± 0.12 | 0.37 ± 0.04** |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 16 | PLA2 | 0.77 ± 0.03 | 0.47 ± 0.17*** |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis involving half to all of extremity (50–100 cm from bite site) | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | |
| Hematologic symptoms | Coagulation parameters abnormal: PT <50–100 sec, PTT <75–100 sec, platelets: 20–50 K/mL, or fibrinogen <50 µg/mL | Coagulation parameters abnormal: PT <50–100 sec, PTT <75–100 sec, platelets: 20–50 K/mL, or fibrinogen <50 µg/mL | |
| 17 | PLA2 | 0.43 ± 0.13 | 0.67 ± 0.06 |
| Local wound | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | Pain, swelling, or ecchymosis within 5–7.5 cm of bite site | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| Central nervous system | Minimal apprehension, headache, weakness, dizziness, chills, or paresthesia | No signs/symptoms | |
| 18 | PLA2 | 0.65 ± 0.18 | 0.58 ± 0.025 |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms | |
| Local wound | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | Pain, swelling, or ecchymosis involving less than half the extremity (7.5–50 cm from bite site) | |
| Gastrointestinal system | Pain, tenesmus, or nausea | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 19 | PLA2 | 0.77 ± 0.11 | 0.39 ± 0.07*** |
| Local wound | Pain, swelling, or ecchymosis within 5-7.5 cm of bite site | No signs/symptoms | |
| Hematologic symptoms | Coagulation parameters slightly abnormal: PT <20 sec, PTT <50 sec, platelets: 100–150 K/mL, fibrinogen: 100–150 µg/mL | No signs/symptoms | |
| 20 | PLA2 | 1.41 ± 0.13 | 0.54 ± 0.23*** |
| Pulmonary system | Moderate respiratory distress, 26–40 bpm | Dyspnea, minimal chest tightness, mild/vague discomfort, and respirations of 20–25 bpm | |
| Cardiovascular system | HR: 100–125 bpm, palpitations, generalized weakness, benign dysrhythmia, or hypotension | No signs/symptoms |
**Significance p< 0.01
***Significance p < 0.001, HR, heart rate; PLA2, phospholipase A2; PT, prothrombin time; PTT, partial thromboplastin time