Introduction. Treating severe acute glyphosate-surfactant poisoning requires
intensive therapy including dialysis. Cases of hemoperfusion and hemodialysis
use in renal failure induced by herbicide ingestion have been reported in the
current medical literature. We present a case report of successful patient
treatment with continuous venovenous hemodiafiltration in acute
glyphosate-surfactant poisoning. Case Outline. A 36-year-old male patient
attempted suicide by drinking approximately 300 ml of glyphosate-surfactant
about an hour before coming to our Clinic. On admittance the patient was
somnolent, normotensive, acidotic and hyperkalemic. Six hours after poison
ingestion there was no positive response to symptomatic and supportive
therapy measures. The patient became hypotensive, hypoxic with oliguric acute
renal failure, so that post-dilution continuous veno-venous hemodiafiltration
was started. During the treatment the patient became hemodinamically stabile,
diuresis was established along with electrolyte and acid-base status
correction and a gradual decrease of blood urea nitrogen and creatinine
levels. After a single 27.5-hour treatment, clinical condition and renal
function parameters did not require further dialysis. Complete recovery of
renal function was achieved on the fifth day. Conclusion. Early introduction
of continuous veno-venous hemodiafiltration with other intensive therapy
measures led to complete recovery in a hemodinamically instable patient.
PLEASURE AND SUFFERING IN THE NURSING WORK IN A PEDIATRIC INTENSIVE THERAPY
UNIT