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{
    "pk": 18401,
    "title": "Compartment Syndrome Following Snake Envenomation in the United States: A Scoping Review of the Clinical Literature",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> Local tissue destruction following envenomation from North American snakes, particularly those within the Crotalinae subfamily, has the potential to progress to compartment syndrome. The pathophysiology of venom-induced compartment syndrome (VICS) is a debated topic and is distinct from trauma/reperfusion-induced compartment syndrome. Heterogeneity exists in the treatment practices of VICS, particularly regarding the decision to progress to fasciotomy. Associations with functional outcomes and evolution in clinical practice since the introduction of Crotalidae polyvalent immune Fab (FabAV) have not been well defined. Our goal was to identify the potential gaps in the literature regarding this phenomenon, as well as illuminate salient themes in the clinical characteristics and treatment practices of VICS.</p>\n<p><strong>Methods:</strong> We conducted this systematic scoping-style review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Records were included if they contained data surrounding the envenomation and hospital course of one or more patients who were envenomated by a snake species native to North America and were diagnosed with compartment syndrome<br>from 1980–2020.</p>\n<p><strong>Results:</strong> We included 19 papers: 10 single- or two-patient case reports encompassing 12 patients, and nine chart reviews providing summary statistics of the included patients. In case reports, the median compartment pressure when reported was 60 millimeters of mercury (interquartile range 55–68), 66% underwent fasciotomy, and functional outcomes varied. Use of antivenom appeared to be more liberal with FabAV than the earlier antivenin Crotalidae polyvalent. Rapid progression of swelling was the most commonly reported symptom. Among the included retrospective chart reviews, important data such as compartment pressures, consistent laboratory values, and snake species was inconsistently reported.</p>\n<p><strong>Conclusions:</strong> Venom-induced compartment syndrome is relatively rare. Existing papers generally describe good outcomes even in the absence of surgical management. Significant gaps in the literature regarding antivenom dosing practices, serial compartment pressure measurements, and functional outcomes highlight the need for prospective studies and consistent standardized reporting.</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "antivenom"
        },
        {
            "word": "Snakes"
        },
        {
            "word": "Crotalinae"
        },
        {
            "word": "Compartment Syndromes"
        }
    ],
    "section": "Toxicology",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5c93k6d6",
    "frozenauthors": [
        {
            "first_name": "John",
            "middle_name": "",
            "last_name": "Newman",
            "name_suffix": "",
            "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia; Vanderbilt University Medical Center, Department of Pathology, Microbiology and Immunology, Nashville, Tennessee",
            "department": "None"
        },
        {
            "first_name": "Colin",
            "middle_name": "",
            "last_name": "Therriault",
            "name_suffix": "",
            "institution": "University of Illinois College of Medicine, Department of Emergency Medicine, Peoria, Illinois",
            "department": "None"
        },
        {
            "first_name": "Mia",
            "middle_name": "S.",
            "last_name": "White",
            "name_suffix": "",
            "institution": "Woodruff Health Sciences Center Library, Emory University, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Daniel",
            "middle_name": "",
            "last_name": "Nogee",
            "name_suffix": "",
            "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia; Georgia Poison Center, Atlanta, Georgia",
            "department": "None"
        },
        {
            "first_name": "Joseph",
            "middle_name": "E.",
            "last_name": "Carpenter",
            "name_suffix": "",
            "institution": "Emory University School of Medicine, Department of Emergency Medicine, Atlanta, Georgia; Georgia Poison Center, Atlanta, Georgia",
            "department": ""
        }
    ],
    "date_submitted": "2023-07-13T19:54:24+02:00",
    "date_accepted": "2023-07-13T19:54:24+02:00",
    "date_published": "2024-06-14T15:00:00+02:00",
    "render_galley": {
        "label": "Final Article",
        "type": "pdf",
        "path": "https://journalpub.escholarship.org/westjem/article/18401/galley/14446/download/"
    },
    "galleys": [
        {
            "label": "Layout",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18401/galley/10126/download/"
        },
        {
            "label": "Final Article",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/18401/galley/14446/download/"
        }
    ]
}