Thromboelastometry analysis of severe North American pit viper-induced coagulopathy: A case report

In the setting of a severe intravascular pit viper envenomation, thromboelastometry correlated well with “traditional” measures. During recovery, ROTEM® demonstrated measurable improvements in the extrinsic coagulation pathway while the INR remained between 1.5 and 1.6. Patient's intestinal necrosis may have resulted from microvascular thrombosis due to Crotalinae venom. The patient's ultimate recovery necessitated a coordinated multidisciplinary effort. ROTEM® abnormalities after North American pit viper envenomation may be more sensitive than “traditional” measures and may have prognostic value to determine the severity of envenomation, but further research to define its utility is required.