Şahin Tülay YILDIZ, Tülay HOŞTEN, Kamil TOKER, Mine SOLAK

Yaşamı tehdit eden akut lityum intoksikasyonu ve tedavi yaklaşımları (Olgu sunumu)

Lityum tedavisi alan hasta sayısının artması ve lityumun terapötik indeksinin dar olması nedeniyle toksisitesi yaygınlaşmaktadır. İntihar girişimi amacıyla lityum, mianserin hidroklorür, biperiden hidroklorür ve alprazolam alan 50 yaşında bayan hasta entübe bir halde yoğun bakım ünitesine kabul edildi. Bipolar affektif bozukluk nedeniyle 10 yıldır lityum kullanmakta olan hastanın serum lityum düzeyi 8.30 mEq L1 olarak tespit edildi. Zorlu diürez, devamlı venovenöz hemodiyafiltrasyon ve hemodiyaliz uygulanan hastanın yoğun bakım ünitesine yatışının 17. günü lityum düzeyi 0.2 mEq L1 olarak ölçüldü ve 39. gün bilinç açık, koopere olarak psikiyatri servisine gönderildi. Bu olgu sunumunda, yaşamı tehdit eden lityum intoksikasyonu ile gelen hastamızda zorlu diürez, devamlı venovenöz hemodiyafiltrasyon ve takibinde aralıklı hemodiyaliz uygulamalarımızı değerlendirmeyi amaçladık.

Anahtar Kelimeler:

Zehirlenme, Lityum, Orta yaşlı, Biperiden, Kadın, Mianserin, İntihar, girişim

Life-threateining acute lithium intoxication and treatment methods (Case report)

Because of the narrow therapeutic index of lithium and the increasing number of patients on long-term therapy, toxicity is becoming more common. A 50-year-old woman was admitted to the intensive care unit after taking an intentional overdose of lithium tablets, mianserin hydrochloride, biperiden hydrochloride, and alprazolam in a suicide attempt and being intubated. The serum lithium level of the patient, who had previously been treated with lithium for 10 years due to a bipolar affective disorder, was 8.30 mEq L1 on admission. The patient was treated by forced diuresis, continuous venovenous hemodiafiltration (CWHDF) followed by hemodialysis. On the seventeenth day in the intensive care unit, the lithium level was 0.2 mEq L'. She was discharged to the psychiatric ward in a fully conscious and cooperative state on the thirty-ninth day of intensive care. In this case report, we aimed to evaluate our practice on a patient with life-threatening acute lithium intoxication, who was treated successfully with forced diuresis and CWHDF followed by hemodialysis.

Keywords:

Poisoning, Lithium, Middle Aged, Biperiden, Female, Mianserin, Suicide, Attempted,

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