How did outcomes differ among lithium-toxic patients not receiving hemodialysis in whom EXTRIP would support it but it would not be recommended based on Paris criteria?
Neurologic symptoms worsened in 21% of patients. A retrospective evaluation of poison center data identified 219 patients in whom hemodialysis was recommended or performed for lithium toxicity. A total of 86 patients met criteria for dialysis based on EXTRIP suggestions but did not meet Paris criteria recommendations. Of these, 19 patients did not receive hemodialysis, 4 of whom deteriorated including 1 death.
DiSalvo PC, et al. Comparison of the EXtracorporeal TReatments In Poisoning (EXTRIP) and Paris criteria for neurotoxicity in lithium poisoned patients. Br J Clin Pharmacol 2021;87(10):3871-3877. doi: 10.1111/bcp.14802.