Fasciotomy in Snake Bite Victims and Renal Outcome in a Tertiary Care Hospital

Sruthi Balla, M. Seenivasan, C. Anandi, S.A.K. Noor Mohammed, P. Nagrajan
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Abstract

Background: Snake bite is a neglected tropical disease. More than 50% of death due to snake bite in the world occurs in India. Acute kidney injury (AKI) is the cause of morbidity and mortality in viper bite. The compartment syndrome is a rare manifestation of snake bite. There is paucity of data on the role of fasciotomy in viper bite.Methods: A prospective observational study was done in patients admitted to a tertiary care hospital in southIndia, with snake bite-associated acute kidney injury, from March 2018 to March 2020.Results: Sixteen % of patients underwent fasciotomy following snake bite. We compared the renal outcome of 21 patients, who had undergone fasciotomy following snake bite, with 65 patients with dialysis-requiring acute kidney injury following snake bite. The patients in the fasciotomy group had a lower peak serum creatinine (5.3 mg/dl), needed less number of dialysis sessions (3.9) and were on lesser number of days (6.1) on dialysis following snake bite, when compared with the group not needing fasciotomy.Conclusion: In snake bite patients presenting with compartment syndrome, fasciotomy should be considered in view of favourable renal outcome.
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一家三甲医院为蛇咬伤患者实施的筋膜切开术和肾功能结果
背景:蛇咬伤是一种被忽视的热带疾病:蛇咬伤是一种被忽视的热带疾病。全世界因被蛇咬伤而死亡的人中,50%以上发生在印度。急性肾损伤(AKI)是毒蛇咬伤的发病和死亡原因。储室综合征是蛇咬伤的一种罕见表现。有关筋膜切开术在毒蛇咬伤中的作用的数据很少:方法:2018 年 3 月至 2020 年 3 月,对印度南部一家三级医院收治的蛇咬伤相关急性肾损伤患者进行了前瞻性观察研究:16%的患者在被蛇咬伤后接受了筋膜切开术。我们比较了 21 名被蛇咬伤后接受筋膜切开术的患者与 65 名被蛇咬伤后需要透析治疗的急性肾损伤患者的肾脏预后。与无需进行筋膜切开术的患者相比,筋膜切开术组患者的血清肌酐峰值(5.3 mg/dl)较低,需要的透析次数(3.9 次)较少,被蛇咬伤后透析的天数(6.1 天)也较少:结论:对于出现储室综合征的蛇咬伤患者,应考虑进行筋膜切开术,以获得良好的肾脏治疗效果。
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