Post-snake bite compartment syndrome : Predictors

The indentification of snake species is often difficult at the time of presentation of snake bite and as the interaction between the victim and snake venom is variable.

Hsu et.al. conducted a single center retrospective study to find out the possible predictors of the post-snake bite compartment syndrome (PSCS). They found out that:

  1. Elevated WBC and AST can be useful predictors of PSCS
  2. Cutoff value for WBC: 11,650/μL
  3. Cutoff value for AST: 33.5 U/L

What may be the explanation for WBC and AST as the markers of post-snake bite compartment syndrome?

These markers may indicate an increase in the inflammatory or cytokine reaction after a severe snakebite and envenomation. Proteins and cytokines produced during the acute phase will induce further leukocytosis. Release of AST from RBC from acute hemolysis and skeletal muscle from necrosis causes further rise in AST.

Advice from the study

Patients with snakebites and locoregional symptoms with elevated markers should be observed for 48 h to exclude the possibility of PSCS.

Further reading: Hsu, C., Chuang, J., Hsu, Y. et al. Predictors of the development of post-snakebite compartment syndrome. Scand J Trauma Resusc Emerg Med 23, 97 (2015). https://doi.org/10.1186/s13049-015-0179-y


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