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General Recommendation

  • ECTR is recommended in severe Tl poisoning (1D)



ECTR is indicated if ANY of the following conditions are present:

  • If Tl exposure is highly suspected on the basis of history or clinical features (2D)

  • Assuming Tl concentrations are readily available, if Tl concentration is >1.0 mg/L (4.9 µmol/L) (2D)


Timing of ECTR

  • ECTR should be initiated as soon as possible, ideally within 24–48 hr of Tl exposure (1D)


Cessation of ECTR

  • is suggested until Tl serum concentration is 0.1 mg/L (0.5 µmol/L) for a minimal duration of 72 hr (2D)


Choice of ECTR

  • Intermittent hemodialysis is the preferred initial ECTR, especially after an acute Tl ingestion (1D) Intermittent hemoperfusion or continuous renal replacement modalities are valid alternatives if intermittent hemodialysis is not available (1D) 



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