Acute Pancreatitis in Scorpion Envenoming Syndrome: Insulin-Glucose Administration Reverses Haemodynamic Changes, Pulmonary Edema and Other Clinical Manifestations Due to Scorpion (Mesobuthus tamulus Concanesis, Pocock [Buthidae family]) Stings

Death due to poisonous scorpion (Buthidae family) stings is a common event in the developing countries. Scorpion envenoming syndrome results in autonomic storm, release of catecholamines, angiotensin II, glucagon, glucocorticoids, either suppressed insulin secretion or hyperinsulinemia; hyperglycemia, lipolysis – sudden increase in free fatty acids (FFA), acute myocarditis, disseminated intravascular coagulation, cardiovascular disturbances, pulmonary oedema, acute pancreatitis, and many clinical manifestations. Under these altered hormonal mileu, insulin administration reversed the metabolic and ECG changes induced by scorpion envenoming in the experimental animals and in scorpion sting victims. Insulin has a primary metabolic role in preventing, counter-acting and reversing the metabolic, cardiovascular, haemodynamic, and neurological manifestations and pulmonary oedema induced by scorpion envenoming and reversing all the deleterious effects of FFA by inhibiting the catecholamine induced lipolysis, and increase intra-cellular K+, facilitating glucose transport to the myocardium and glucose metabolism through different pathways. Profuse sweating, excessive salivation and abdominal pain are the triad of symptoms of ominous significance in scorpion sting victims with acute pancreatitis. Laryngeal spasm and respiratory failure are more common with acute pancreatitis. Continuous infusion of regular crystalline insulin should be given at the rate of 0.3 U/g glucose and glucose at the rate of 0.1 g/kg body weight/hour, for 48–72 hours, with supplementation of potassium as needed and maintenance of fluid, electrolytes and acid-base balance.

Treatment of multiple system organs failure after severe craniocerebral injury / 中国康复理论与实践

@#ObjectiveTo analyze the development mechanism and investigate the more effective therapeutic method of the multiple system organs failure (MSOF) after severe craniocerebral injury.MethodsThe clinical data of 21 MSOF cases after severe craniocerebral injury was analyzed retrospectively.ResultsOf all 21 cases, 2 cured, 7 mended and 12 died with death rate 57% and deformity rate 33.3%.ConclusionTo severe craniocerebral injury, comprehensive, timely and effective therapeutic method is the key to reduce the occurrence of MSOF and the rate of death and deformity.