These articles describe 30 apparently-unique cases of severe envenomation. From this group, five cases did not contain sufficient data about the clinical course after FabAV administration to judge whether the manifestations of severe envenomation responded to therapy, and one case was determined to be included in two different series; these cases were therefore excluded[10,20-24]. The remaining 24 cases from 19 published reports are presented in Table ​Table33[4,10,13,20,22,25-38]. Figure 1 Article identification and selection process. This information is also presented as an attached file. Table 3 Published

cases of Inhibitors,research,lifescience,medical severe envenomation treated with FabAV Five cohort studies and Inhibitors,research,lifescience,medical fourteen non-cohort studies were identified. Two of the cohort studies collected data prospectively, two collected

data retrospectively, and one used both prospective and retrospective data collection. All of the non-cohort studies were of retrospective design. Seven severely envenomated patients were reported in the cohort studies, and 17 severely envenomated patients were described in the non-cohort studies. research initial response to FabAV therapy Sixty-five specific severe venom effects were reported in these 24 patients. The initial response to FabAV treatment for these specific severe venom effects was: improved/resolved, 50 Inhibitors,research,lifescience,medical effects (77%); no improvement, 11 effects (17%); not reported, 4 effects (6%). All of the 22 specific venom effects (100%) experienced by the seven patients in the cohort studies improved after FabAV administration. In contrast, of the 43 specific venom effects experienced by the patients in the non-cohort studies, 28 effects improved or resolved (65%), 11 effects did not improve (26%), and the response of 4 effects were not reported (9%). Initial control of the envenomation Inhibitors,research,lifescience,medical syndrome Inhibitors,research,lifescience,medical was achieved in 12 patients (50%), not achieved in 9 patients (38%), and not fully reported in 3 patients (13%). All seven (100%) of the severely envenomated patients in the

cohort studies achieved initial control. Once again, the response to initial therapy was not as good in the patients reported in non-cohort studies. Among these 17 patients, initial control of the envenomation syndrome was achieved in 5 patients (29%), not achieved in 9 patients (53%), and incompletely documented in 3 patients (18%). The median dose of FabAV used to achieve initial control MRIP of the envenomation syndrome in these 12 patients was 6 vials (range: 4 – 18 vials). Persistent severe venom effects One or more persistent severe venom effects were reported in 0/7 patients reported in cohort studies (0%), and in 9/17 patients in non-cohort reports (53%). These cases are summarized in Table ​Table44[27-30,34,36,38]. These effects consisted of limb swelling, limb pain, soft tissue bleeding, thrombocytopenia, neurotoxicity, or compartment syndrome. Response to therapy was not reported for four patients, summarized in Table ​Table55[26,27,32,35].