da Silva O A, López M, Godoy P
Am J Trop Med Hyg. 1979 Mar;28(2):401-7. doi: 10.4269/ajtmh.1979.28.401.
Twenty-nine patients with acute renal failure following bites by snakes of the genera Crotalus and Bothrops were treated in an Intensive Care Unit (ICU). Eight were given conservative treatment. Peritoneal dialysis was necessary in 21 patients, and hemodialysis in one of these. The main complications occurring while the patients were in the ICU were pulmonary edema (5 cases), respiratory failure (4), cardiac arrest (4), and hypovolemic shock (1 case). Three patients died with respiratory and hemodynamic disturbances while in the ICU, one of them during the polyuric phase. Twenty-four patients were discharged from the hospital with no clinical or laboratory evidence of renal failure. Two patients developed bilateral cortical necrosis of the kidney. One of them died in the general ward after interruption of dialysis and the other was discharged from the hospital with chronic renal failure. It was not possible to perform a kidney transplantation. The importance of the ICU in the recovery of such patients is stressed.
29例被响尾蛇属和矛头蝮属蛇咬伤后出现急性肾衰竭的患者在重症监护病房（ICU）接受治疗。8例接受了保守治疗。21例患者需要进行腹膜透析，其中1例还进行了血液透析。患者在ICU期间出现的主要并发症有肺水肿（5例）、呼吸衰竭（4例）、心脏骤停（4例）和低血容量性休克（1例）。3例患者在ICU期间因呼吸和血流动力学紊乱死亡，其中1例死于多尿期。24例患者出院时无肾衰竭的临床或实验室证据。2例患者发生双侧肾皮质坏死。其中1例在透析中断后死于普通病房，另1例出院时患有慢性肾衰竭。无法进行肾移植。强调了ICU在这类患者康复中的重要性。
