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martes, 13 de septiembre de 2016

Chronic, asymptomatic hyperlithemia

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.