{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:15Z","timestamp":1791273315286,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Snake envenomation remains a significant cause of morbidity worldwide, with antivenom serving as the cornerstone of treatment. This case series describes outcomes of three male patients (ages 34\u201363\u2009years) with severe envenomation who demonstrated progressive local swelling and coagulopathy despite receiving at least 15 vials of antivenom. All received adjunctive hemoperfusion using a Nipro HA230 cartridge via femoral venous access (six two\u2010hour sessions over three days). All patients survived and were discharged after 4\u20135\u2009days with normalized coagulation parameters and resolved swelling. No hemoperfusion\u2010related complications were documented. Total antivenom ranged from 15 to 25 vials. These findings suggest hemoperfusion may be a feasible adjunctive therapy in refractory cases, though the observational design precludes definitive conclusions. Hemoperfusion should be considered experimental, reserved for severe refractory cases in well\u2010resourced settings.<\/jats:p>","DOI":"10.1002\/ccr3.73512","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:53:08Z","timestamp":1790052788000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemoperfusion as Adjunctive Therapy in Severe Snake Envenomation Refractory to Antivenom: A Case Series"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2046-1272","authenticated-orcid":false,"given":"Sayed Masoud","family":"Hosseini","sequence":"first","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9401-0781","authenticated-orcid":false,"given":"Shahin","family":"Shadnia","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4872-9610","authenticated-orcid":false,"given":"Babak","family":"Mostafazadeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8785-8207","authenticated-orcid":false,"given":"Mitra","family":"Rahimi","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-525X","authenticated-orcid":false,"given":"Faraz","family":"Zandiyeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida Rabiei","family":"Nezhad","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman Erfan Talab","family":"Evini","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Toxicological Research Center, Excellence Center of Clinical Toxicology, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01698-7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0013603"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.5812\/atr.6445"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/2221-6189.272859"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fevo.2019.00218"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-024-06019-6"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2020.114135"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxcx.2023.100152"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.35975\/apic.v29i5.2870"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins15120675"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/vec.12949"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000532050"},{"key":"e_1_2_12_14_1","first-page":"96","article-title":"Extracorporeal 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R.Jose et\u00a0al. \u201cThe Role of Plasmapheresis in Snake Envenoming: A Systematic Review \u201dmedRxiv 2024.09 27.24314476 (2024).","DOI":"10.1101\/2024.09.27.24314476"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819881459"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73512","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73512","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:40:43Z","timestamp":1791272443000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccr3.73512"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73512","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73512"}}