What are the proposed Paris criteria for extracorporeal removal of lithium?
Serum lithium concentration > 5.2 mmol/L or creatinine > 200 mcmol/L. A retrospective review identified 128 patients with lithium concentration above 1.5 mmol/L managed between 1993-2013 in the ICU of a single institution. Of 46 patients meeting criteria, those receiving dialysis (n=21) had significantly lower incidence of persistent neurologic impairment on ICU discharge compared to those not receiving dialysis, 15% vs. 54%.
Vodovar D, et al. Lithium poisoning in the intensive care unit: predictive factors of severity and indications for extracorporeal toxin removal to improve outcome. Clin Toxicol (Phila) 2016;54(8):615-623. DOI: 10.1080/15563650.2016.1185110
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