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Abroug F, Nouira S, El Atrous S, Besbes L, Boukef R, Boussarsar M, Marghli S, Eurin J, Barthelemy C, El Ayeb M, Dellagi K, Carayon A. A canine study of immunotherapy in scorpion envenomation. Intensive Care Med 2003; 29:2266-2276. [PMID: 12955186 DOI: 10.1007/s00134-003-1947-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2003] [Accepted: 07/15/2003] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the effects of scorpion venom and antivenom in experimental envenomation. DESIGN Prospective, controlled animal study. SETTING University research laboratory SUBJECTS Twenty-nine anesthetized and ventilated dogs. INTERVENTIONS The first group of animals had venom alone (0.05 mg/kg). Animals from the second group had simultaneous administration of 10 ml of scorpion antivenom (SAV). In the third and fourth groups, 10 ml and 40 ml SAV, respectively, were injected 10 min following venom. MEASUREMENTS AND RESULTS Hemodynamic parameters using right heart catheter were recorded and dosage of catecholamines, neuropeptide Y (NPY), endothelin-1, and atrial natriuretic peptide (ANP) were performed at baseline and during 60 min following envenomation. In the control group, at 5 min, there was a sharp increase in pulmonary artery occluded pressure (PAOP, from 2 mmHg to 23 mmHg), mean arterial pressure (MAP, from 125 mmHg to 212 mmHg) and systemic vascular resistance (SVR, from 2450 dyn sec(-1 )m(5) to 5775 dyn sec(-1 )m(5), P<0.05 for all). Heart rate, cardiac output, and stroke volume decreased. There was a 40-fold increase in epinephrine and norepinephrine plasma concentrations. Circulating NPY and ANP dosages increased too. PAOP and MAP decreased thereafter to reach baseline levels. Simultaneous administration of SAV with venom totally offset the hallmarks of scorpion envenomation. Delayed administration of SAV at any dosage failed to alter the features of scorpion envenomation. CONCLUSION While simultaneous administration of SAV and scorpion venom is effective in preventing scorpion envenomation-related manifestations, delayed administration of SAV, either at standard or elevated dosages, failed to alter any of the scorpion envenomation features.
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Affiliation(s)
- Fekri Abroug
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia.
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia.
| | - Semir Nouira
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Souheil El Atrous
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Lamia Besbes
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Riadh Boukef
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Mohamed Boussarsar
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Soudani Marghli
- Intensive Care Unit, CHU F Bourguiba, 5000, Monastir, Tunisia
- Unité de Recherche (99/UR/088-59), Faculté de Médecine, Monastir, Tunisia
| | - Joëlle Eurin
- Laboratoire de Biochimie, Upres 1390 CHU, Pitié-Salpêtrière, Paris, France
| | | | | | | | - Alain Carayon
- Laboratoire de Biochimie, Upres 1390 CHU, Pitié-Salpêtrière, Paris, France
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Tarasiuk A, Menascu S, Sofer S. Antivenom serotherapy and volume resuscitation partially improve peripheral organ ischemia in dogs injected with scorpion venom. Toxicon 2003; 42:73-7. [PMID: 12893063 DOI: 10.1016/s0041-0101(03)00102-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We tested the hypothesis that fluid resuscitation combined with antivenom serotherapy given after injection of scorpion venom may increase cardiac output (CO) and blood pressure (BP) and prevent the decline in bicarbonate, pH and gastric perfusion. Seventeen anesthetized, mechanically ventilated dogs were given 0.1 mg/kg i.v. venom of the scorpion Leiurus quinquestriatus. The dogs were randomized into three groups: six dogs were given venom alone; three dogs were given 6 ml of antivenom 1 minute before venom injection; eight dogs were given 6 ml of antivenom and 20 ml/kg of synthetic colloid solution, 20 min after venom injection. Parameters reflecting respiratory and circulatory functions were determined at baseline and 120 min after venom injection. Scorpion venom caused a decrease in CO, BP, pH and HCO3-. Gastric mucosal perfusion was severely affected as assessed by mucosal pH (pHi) and the gradient between mucosal and arterial pCO2 (delta pCO2). Antivenom given before venom injection prevented all the effects induced by the venom. Antivenom and fluid given 20 min after venom injection caused a marked increase in CO and BP, but had no effect on pH and HCO3- decline (compared with venom alone). Gastric perfusion slightly improved as the increase in delta pCO2 was attenuated. The combination therapy of antivenom and fluid in this dog model is superior to the therapy of each of them alone. The marked and long-standing improvement of CO is promising and may suggest improvement in HCO3- and pH with time.
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Affiliation(s)
- Ariel Tarasiuk
- Pediatric Intensive Care Unit, Division of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
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Tarasiuk A, Akkerman A, Sasson L, Sofer S. Effect of Venom from the Scorpion Leiurus Quinquestriatus on Rat Vascular Aortic Rings. J Basic Clin Physiol Pharmacol 2003; 14:309-21. [PMID: 15198304 DOI: 10.1515/jbcpp.2003.14.4.309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study was designed to examine the effects of venom from the scorpion Leiurus quinquestriatus hebraeus (Lqh) on the contractility of rat aortic rings. We first examined the effect of Lqh venom on the contractile tension of isolated rat vascular aortic rings and then whether long-term exposure to the venom reduces the contractility of vascular smooth muscle by increasing the production of nitric oxide. Following the administration of 33 microg/mL of crude Lqh venom, contractile tension increased by 18.9 +/- 11.4 percent. The administration of 2.4 x 10(-7) M noradrenaline (NA) led to a 31.6 +/- 8.2 percent increase in tension (p < 0.01). The effects induced by NA and Lqh venom were similar and additive (p < 0.01). Pretreatment with the alpha-adrenergic blocker phenoxybenzamine (0.2 microM) eliminated the effect of the venom, whereas the calcium-channel blocker verapil (8.3 microM) merely attenuated the effect. Incubation of the rings with Lqh venom for 16 to 18 h, followed by NA stimulation, led to a 15 to 20 percent decrease in tension (p < 0.001). Treatment with N-omega-nitro-L-arginine methyl ester (110 microM), a constitutional nitric oxide inhibitor, restored the tension to control values. Treatment with S-methyl-isothiourea (0.1 microM), an inducible nitric oxide synthesis inhibitor, had no effect on contractile tension. The results of the present study suggest that the effect of Lqh venom on isolated aortic rings is induced via sympathetic nerve terminals. Calcium had little effect on the smooth muscle contractility of aortic rings incubated with the venom. No evidence was found to support nitric oxide synthesis after the long-term exposure of the rings to Lqh venom.
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Affiliation(s)
- Ariel Tarasiuk
- Pediatric Intensive Care Unit, Division of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
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