Conclusion
In this retrospective data set, application of the Paris guidelines would have resulted in fewer overall cases of hemodialysis for lithium poisoned patients, but would have failed to identify a statistically significant number of patients who may have benefited from expedited extracorporeal drug removal. While the EXTRIP criteria results in an increase in the use of hemodialysis, overall patient outcomes were improved, and fewer patients deteriorated. A prospective study is needed to more conclusively determine the relative performance characteristics of both EXTRIP and Paris criteria.
Table 1: The EXTRIP and Paris Criteria for Hemodialysis and Lithium Poisoning