Effects of poisoning on serum enzyme activities, coagulation, and fibrinolysis

Prolonged coma due to acute overdosage with hypnotic drugs is shown to be associated with a pronounced increase in the activity of serum creatine kinase and in the concentration of fibrin degradation products and with less pronounced abnormalities of other serum enzymes and of other indices of coagulation and fibrinolysis. Evidence is presented that skeletal muscle damage occurs and that this is related to the coagulation abnormality. These findings probably explain some of the non-specific features such as fever which commonly occur in recovery from severe poisoning.

Acidaemia and salicylate poisoning in adults

A review of the arterial acid-base status on admission to hospital of 62 adults with severe salicylate poisoning showed that arterial pH was normal or high in most patients, but low in 8. The mean plasma salicylate concentrations of the acidaemic and nonacidaemic patients were similar and the difference in arterial pH was associated with a marked fall in standard bicarbonate in the former group. No significant difference of Pco(2) between the two groups was found, and hence no simple relationship exists between hypocapnia and the development of acidaemia in salicylate poisoning. Acidaemia is shown to be associated with impaired consciousness and to carry a grave prognosis.