Haemodialysis followed by continuous veno-venous haemodiafiltration in lithium intoxication; a model and a case.
For severe lithium intoxication haemodialysis is recommended to lower serum lithium levels rapidly. Frequently, serum lithium levels rebound after dialysis and repeated dialysis is needed. This is the first report of an adult patient with severe lithium intoxication who underwent haemodialysis (HD) followed by continuous veno-venous haemodiafiltration (CVVHDF). Mean lithium clearances with HD and CVVHDF were 173 and 61 ml/min, respectively. Serum lithium levels were rapidly lowered and did not rebound. Two compartment simulations illustrate that HD followed by CVVHDF is the most effective strategy for removing lithium from the intracellular compartment.
Meertens
John H J M
JH
Department of Critical Care, Intensive and Respiratory Care Unit, University Medical Center Groningen, The Netherlands. j.h.j.m.meertens@int.umcg.nl
Jagernath
Danny R
DR
Eleveld
Douglas J
DJ
Zijlstra
Jan G
JG
Franssen
Casper F M
CF
D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D001825:Body Fluid Compartments; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006440:Hemofiltration; D006801:Humans; D018020:Lithium Compounds / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D008954:Models, Biological; D006435:Renal Dialysis
D000928:Antidepressive Agents; D018020:Lithium Compounds