Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 01 28 1417 1417 EN Mohammad Kurniawan Departement of Anesthesiology and Intensive Care, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. & Faculty of Medicine, IPB University, Bogor, Indonesia. & Departement of Anesthesiology and Intensive Care, Bakti Pajajaran Regional General Hospital, Bogor, Indonesia. Riyadh Firdaus Departement of Anesthesiology and Intensive Care, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. Sidharta Manggala Departement of Anesthesiology and Intensive Care, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. 2025 09 19 2025 10 03 Snakebite envenomation is a medical emergency with potentially fatal systemic complications. We report a case of a 32-year-old male patient who presented to the Emergency Department with a complaint of a snakebite on his right ear. On arrival, he didn’t have signs of bleeding, fever, or swelling. Two hours after admission, the patient developed cardiac arrest and required mechanical ventilation. Although resuscitation was successful, the patient’s condition deteriorated, with progressive neurological and motor deficits, despite unremarkable findings on head CT scans and chest X-rays. Given progressive neurological and motoric deficits, hemoperfusion was initiated six hours post-envenomation as an adjunctive therapy. The procedure lasted six hours using a standard hemoperfusion cartridge. The patient demonstrated significant neurological recovery within 22 hours post-procedure, and he was successfully extubated on day 4. This case highlights the potential role of hemoperfusion as an adjuvant treatment in managing venomous snakebite envenomation, especially in places with limited species-specific antivenom availability. Early recognition of systemic complications and timely initiation of hemoperfusion may improve neurological outcomes in critically envenomed patients. https://aacc.tums.ac.ir/index.php/aacc/article/view/1417