{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:52:50Z","timestamp":1791535970620,"version":"4.3.4"},"reference-count":9,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Public Promoting Association Kura Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Snakebite envenomation remains a leading cause of preventable mortality in Southeast Asia. We report a 52-year-old woman from Leyte, Philippines, who sustained a bite from a probable king cobra (Ophiophagus sp.) and arrived at a tertiary center in cardiopulmonary arrest. Return of spontaneous circulation was achieved after a single resuscitation cycle. Initial treatment with Purified Cobra Antivenom, a monovalent product directed against Naja philippinensis, produced only minimal improvement. Escalation to Taradoc\u00ae (VINS Bioproducts Limited, India), a trivalent antivenom with additional coverage for Ophiophagus sp., was followed by progressive neurologic recovery, extubation on hospital day 3, and discharge without deficits. This case illustrates the potential role of polyvalent antivenom escalation in elapid envenomation refractory to monovalent therapy.<\/jats:p>","DOI":"10.1093\/trstmh\/trag127","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:01:33Z","timestamp":1790164893000},"source":"Crossref","is-referenced-by-count":0,"title":["Probable\n                    <i>Ophiophagus<\/i>\n                    sp. envenomation with cardiopulmonary arrest: sequential antivenom escalation in the Philippines"],"prefix":"10.1093","author":[{"given":"Paolo S","family":"Ortillo","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Eastern Visayas Medical Center , Tacloban City 6500 ,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2011-485X","authenticated-orcid":false,"given":"Yoshihiro","family":"Aoki","sequence":"additional","affiliation":[{"name":"Coordination Office for Emergency Medicine and International Response, Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Paghubasan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Eastern Visayas Medical Center , Tacloban City 6500 ,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1432-3308","authenticated-orcid":false,"given":"Patrick Joseph","family":"Tiglao","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of the Philippines\u2014Philippine General Hospital , Manila 1000 ,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Coordination Office for Emergency Medicine and International Response, Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Yamano","sequence":"additional","affiliation":[{"name":"Coordination Office for Emergency Medicine and International Response, Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Coordination Office for Emergency Medicine and International Response, Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Tasaki","sequence":"additional","affiliation":[{"name":"Coordination Office for Emergency Medicine and International Response, Acute and Critical Care Center, Nagasaki University Hospital , Nagasaki 852-8501 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rizza D","family":"Devora","sequence":"additional","affiliation":[{"name":"Poison Control Center, Eastern Visayas Medical Center , Tacloban City 6500 ,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"2026100904393131200_bib1","doi-asserted-by":"crossref","first-page":"106942","DOI":"10.1016\/j.toxicon.2022.106942","article-title":"Preclinical assessment of VPEAV, a new trivalent antivenom for elapid snakebite envenoming in the Philippines: proteomics, immunoreactivity and toxicity neutralization","volume":"220","author":"Chan","year":"2022","journal-title":"Toxicon"},{"key":"2026100904393131200_bib2","volume-title":"Algorithms of Common Poisonings","author":"National Poison Management and Control Center, University of the Philippines Manila \u2013 Philippine General Hospital","year":"2025","edition":"4th edn."},{"key":"2026100904393131200_bib3","doi-asserted-by":"crossref","first-page":"107751","DOI":"10.1016\/j.toxicon.2024.107751","article-title":"A fatal snakebite envenomation due to king cobra (Ophiophagus hannah) in the Eastern Visayas, Philippines","volume":"244","author":"Arrieta","year":"2024","journal-title":"Toxicon"},{"key":"2026100904393131200_bib4","doi-asserted-by":"crossref","first-page":"17063","DOI":"10.1038\/nrdp.2017.63","article-title":"Snakebite envenoming","volume":"3","author":"Guti\u00e9rrez","year":"2017","journal-title":"Nat Rev Dis 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