RESUMO
This study was done to determine whether high or low dose of anti-snake venom [ASV] is better in coagulopathy in victims of envenoming by vipers. This retrospective study was conducted on the 154 patients [Mean age +/- SD, Range] of viper snake bites who were referred to the emergency ward of Razi Hospital, Ahvaz, Iran over 2 years period [2004 - 2006]. According to the treatment dosage the patients were divided in two groups include group 1 [78 cases], low dose regimen and group 2 [76 cases], high dose one. In group 1, the treatment was performed by administration of 4 to 6 vials of ASV through intravenous infusion. In group 2, the patients were given 5 to 10 vials of ASV as an initial dose. In low dose regimen, the number of received packed red blood cell was higher [14 vs. 3] in comparison with high dose group. The number of ASV vials the patients received was 5.5and 21.06 in group 1 and 2, respectively [5.5 +/- 1.7 vs. 21.06 +/- 10.89; p < 0.01]. The difference in frequency of coagulopathy complications, and need for using packed red blood cell were statistically significant [96.2% and 17.9% in group 1 vs. 34.2% and 3.9% in group 2, p < 0.01]. It seems that cautious usage of high dose of ASV [10 - 20 vials] without very special concerns about the cost, dose, and without hazardous side effects is essential for the routine management of sever snake envenoming