Neurotoxic snake bite with respiratory failure

Thirteen patients with severe neuroparalytic snake envenomation admitted in intensive care unit with respiratory failure over a four months period. Initially ptosis and ophthalmoplegia, followed by bulbar palsy and respiratory muscle weakness was the common sequele. All of them received cardio-respiratory support with mechanical ventilation, anti-snake venom (median dose of 20 vials) and anticholinesterase therapy. Except one suffering from hypoxic brain injury due to delayed presentation, rest survived with complete neurological recovery. So good outcome in such cases is related with early cardio respiratory support and anti venom therapy