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Would you recommend CRRT instead of intermittent hemodialysis to prevent lithium rebound in a patient with lithium toxicity after an initial intermittent hemodialysis session?
Answer from: at Academic Institution
I think the best way to approach any "overdose" of a drug that is dialyzable and may have a rebound is to start with hemodialysis and run it until you have achieved your desired response (drug level, improvement in some other parameter) and follow that with CRRT to manage any rebound. This is well s...
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Answer from: at Academic Institution
There are multiple good ways of doing this. CRRT after intermittent hemo is one option. Daily or even more frequent dialysis is another option. SLED/PIRRT is yet another option. I think as long as we start lowering the lithium levels and monitoring them, it is going a long way towards fixing the pro...
Answer from: at Community Practice
No. Rebound of lithium levels after an initial hemodialysis procedure can occur, and depends on the level of the patient's renal function, whether the lithium ingestion was acute or chronic, and the severity of the overdose. Rather than implementing prophylactic CRRT to prevent rebound, I follow lit...
Answer from: at Community Practice
We had one patient with rebound levels, so we started CRRT. This was successful, and it avoided long HD sessions, which required major staffing adjustments.