Insulin administration in severe scorpion envenoming



Título del documento: Insulin administration in severe scorpion envenoming
Revista: The journal of venomous animals and toxins
Base de datos: PERIÓDICA
Número de sistema: 000298654
ISSN: 0104-7930
Autores: 1
2
Instituciones: 1Kurnool Medical College, Department of Medicine, Kurnool, Mumbai. India
2Seth G.S. Medical College, Department of Physiology, Parel, Mumbai. India
Año:
Volumen: 5
Número: 2
Paginación: 200-219
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Experimental
Resumen en inglés The efficacy of insulin-glucose infusion in reversing myocardial damage, haemodynamic changes, peripheral circulatory failure, and pulmonary oedema was evaluated in 25 victims of venomous scorpion stings from the Rayalaseema region in the south of India. Myocardial damage with peripheral circulatory failure was seen in all scorpion sting victims. Ten of these victims also had pulmonary oedema. All the patients received continuous infusion of regular crystalline insulin at the rate of 0.3 U/g of glucose and glucose at the rate of 0.1 g/kg/h with supplementary potassium as needed, inotropic agents, oxygen, as well as maintenance of fluid, electrolytes and acid-base balance. Insulin-glucose infusion was associated with reversal of cardiovascular and haemodynamic changes, and pulmonary oedema in 24 of the 25 victims. One severely envenomed victim admitted 72 hours after the sting died. The scorpion envenoming syndrome with myocardial damage, cardiovascular disturbances, peripheral circulatory failure, pulmonary oedema, and many other clinical manifestations may cause multi-system organ failure (MSOF). It is characterised by a massive release of catecholamines, angiotensin II, glucagon, cortisol, and inhibition of insulin secretion. Under these altered conditions in the hormonal milieu, scorpion envenoming essentially results in a syndrome of fuel-energy deficits and an inability to use the existing metabolic substrates by vital organs, causing MSOF and death. Administration of insulin-glucose infusion to scorpion sting victims appears
Disciplinas: Medicina
Palabras clave: Terapéutica y rehabilitación,
Toxicología,
Veneno,
Daños,
Edema pulmonar,
Pulmones,
Alacranes,
Insulina,
Falla circulatoria periférica
Keyword: Medicine,
Therapeutics and rehabilitation,
Toxicology,
Scorpions,
Damage,
Pulmonary edema,
Lungs,
Venom,
Insulin,
Peripheral circulatory failure
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