1. Haemodialysis followed by continuous veno-venous haemodiafiltration in lithium intoxication; a model and a case.
- Author
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Meertens JH, Jagernath DR, Eleveld DJ, Zijlstra JG, and Franssen CF
- Subjects
- Aged, 80 and over, Antidepressive Agents blood, Antidepressive Agents pharmacokinetics, Body Fluid Compartments, Female, Humans, Lithium Compounds blood, Lithium Compounds pharmacokinetics, Antidepressive Agents poisoning, Depressive Disorder drug therapy, Hemofiltration, Lithium Compounds poisoning, Models, Biological, Renal Dialysis
- Abstract
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.
- Published
- 2009
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