State-of-the-art review of lithium poisoning: almost a must-read

4 out of 5 stars Lithium Poisoning: State of the Art.  Baird-Gunning J et al. J Intensive Care Med 2016 Aug 11 [Epub ahead of print] Abstract This is a very good paper, the best comprehensive review I can remember reading on lithium. It is up to date, with 78 references as recent as 2015. A major reason I liked it so much is that the authors are quire frank about how much we don’t know, and resist giving, for instance, mandates about when to start hemodialysis based on lithium levels. This is a temptation that the authors of the recent ExTRIP review  succumbed to. Interestingly, the two papers share an author (Sophie Gosselin). However, I think the authors missed — or at least failed to emphasize — a key point. With lithium poisoning, as with all toxicology cases, the key to successful treatment begins with basic ABCs and supportive care. This includes adequate hydration, which is crucial. There are many reasons why these patients — especially those with chronic lithium poisoning — present with significant and often under-appreciated volume depletion. The gastrointestinal manifestations of lithium toxicity include nausea, vomiting, and diarrhea. Because of these symptoms, along with lithium-induced mental status changes, fluid intake has typically been deficient. Because it can take days to weeks for chronic lithium toxicity to develop, this deficiency may have been going on for some time. In addition, chronic lithium poisonin...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical lithium poisoning Review TUSH ultrasound Source Type: news

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