Evidence map›Paper›PMID 42536674›Full record

ArticlePLoS neglected tropical diseases2026

Under pressure: Clinical management of venom-induced compartment syndrome in snakebite-A scoping review of the global literature.

Jonathan Steinhorst, John H Amuasi, Paul M N Werker, Abdulrazaq G Habib, Eric J Lavonas, Benno Kreuels, David G Lalloo, Ymkje Stienstra

Abstract readScoping Review
In one paragraph

Article in PLoS neglected tropical diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jonathan SteinhorstDepartment of Internal Medicine/ Infectious Diseases, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0003-1380-6727
John H AmuasiKumasi Center for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Paul M N WerkerDepartment of Plastic Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Abdulrazaq G HabibDepartment of Medicine, Bayero University, Kano, Nigeria.
Eric J LavonasRocky Mountain Poison and Drug Safety, Denver Health, Denver, Colorado, United States of America.
Benno KreuelsResearch Group Neglected Diseases and Envenoming, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
David G LallooCentre for Snakebite Research and Interventions, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Ymkje StienstraDepartment of Internal Medicine/ Infectious Diseases, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundVenom-induced compartment syndrome (VICS) is a rare but severe complication of snakebite which poses unique challenges in diagnosis and treatment. Published literature largely focuses on VICS in the North American context, while information on clinical presentations, diagnostic and treatment approaches, clinical outcomes and associated challenges from the world's most snakebite endemic regions remain fragmented and scarce.

methodsA scoping review using PRIMSA-ScR methodology of the global literature on VICS was performed by searching the PubMed, Embase, and Cochrane databases. Literature was divided into 1) Case reports on VICS and 2) General literature. Clinical data from eligible case reports was extracted to describe management of VICS and associated challenges. Available evidence on diagnostic and treatment strategies was extracted from the general literature.

resultsOf 115 cases of VICS analyzed, most were from Europe (40%); Only 13% and 6% were reported from South-East Asia and Africa respectively. Viperids caused 73% of bites and upper extremities were most frequently affected (63%). Compartment pressure was measured in 38% of patients. Compartment pressure was more commonly measured in the 12% of non-surgically treated patients, none of whom developed ischaemic contracture or required amputation. Coagulopathy was the most common systemic toxicity, present in 40% of patients at admission. Results from eight animal studies support the use of antivenom for treating VICS. Analysis of 17 human observational studies suggests an overdiagnosis of VICS using clinical symptoms alone, highlighting the need to investigate diagnostic tools, such as ultrasound, for diagnosing compartment swelling.

conclusionAntivenom as first-line treatment for VICS is supported by animal and human observational studies. However, additional data is needed to inform decision-making on when fasciotomy is indicated as a rescue therapy. Improved evidence generation will depend on the collection of high-quality clinical and diagnostic observational data from patients treated with antivenom in snakebite-endemic regions.

Indexed as

Compartment SyndromesSnake BitesSnake VenomsAnimalsAntiveninsHumansAntiveninsSnake Venoms

Identifiers

PMID42536674
PMCPMC13427016

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.