PulmCrit
PulmCrit- September 12, 2016 - By Josh Farkas
Factor #1: A single level doesn’t reveal pharmacokinetics
Factor #2: Serum levels don’t predict with brain levels
- Patients with chronic, asymptomatic elevation of lithium levels are at little acute risk of immediate deterioration: their lithium level should fall over time, and they are tolerating their current lithium level well.
- There is no evidence to support the use of dialysis in stable patients with chronic asymptomatic hyperlithemia.
- Some reports suggest that abrupt reduction in lithium levels induced by dialysis may cause neurological deterioration.
- A sensible approach to chronic asymptomatic hyperlithemia in a patient with adequate renal function might be rehydration with close monitoring of lithium levels and clinical status.
There is no evidence to support dialysis for chronic asymptomatic hyperlithemia.