Treatment of lithium intoxication with continuous venovenous hemodiafiltration

Lithium intoxication is an important complication of its frequent use and narrow therapeutic index. Intermittent hemodialysis has been the treatment of choice when emergent extracorporeal lithium clearance is indicated, but postdialysis rebound elevations in lithium concentration with recurrent toxicity have been documented. We report a case of intentional acute on chronic lithium intoxication in which continuous venovenous hemodiafiltration was successfully used. This modality offers the advantage of slow sustained removal of lithium without hemodynamic instability or rebound elevations in lithium concentration.