Lithium Intoxication Management

Indications for Hemodialysis

The American Journal of Kidney Diseases recommends hemodialysis for patients with persistent shock after fluid resuscitation 1
Deterioro significativo de la función renal (TFG <60 ml/min/1.73 m²) con intoxicación por litio is an indication for hemodialysis, according to Praxis Medical Insights 2
Insuficiencia respiratoria that requires mechanical ventilation is an indication for hemodialysis, as per the American Journal of Kidney Diseases 1

Monitorización continua de signos vitales and estado neurológico is recommended, as per Praxis Medical Insights 3
Evaluación de factores precipitantes, such as deshidratación, interacciones medicamentosas, and insuficiencia renal, is necessary, according to Praxis Medical Insights 3
Hidratación adecuada with solución salina normal is recommended, as per Praxis Medical Insights 3
Corrección de electrolitos, especialmente mantener potasio >4 mEq/L, is necessary, according to Circulation 4

Hemodiálisis intermitente is the preferred method for eliminating litio, due to its higher efficacy, as per Critical Care 5
Hemofiltración venovenosa continua (CVVH) is an acceptable alternative if hemodiálisis is not available, according to Critical Care 5
El tratamiento con sulfato de magnesio may be useful in cases of arritmias ventriculares associated with litio intoxication, as per Circulation 4

Medición de niveles séricos de litio every 2-4 hours until estabilización is recommended, as per Praxis Medical Insights 3
Monitorización de función renal, electrolitos, and signos vitales is necessary, according to Praxis Medical Insights 2

Identificación de factores precipitantes, such as deshidratación, uso concomitante de AINE, and insuficiencia renal, is necessary, as per Praxis Medical Insights 2
Monitorización regular de niveles séricos de litio during treatment is recommended, according to Praxis Medical Insights 3
Educación al paciente sobre signos tempranos de toxicidad is necessary, as per Praxis Medical Insights 2