The significance of acid-base measurements in the management of salicylate intoxication

A review of acute salicylate poisoning

A five-year review of patients admitted to the Royal Adelaide Hospital with Salicylate overdose is presented. Despite a significant increase in the total patients admitted, those with Salicylate overdose show a steady decrease in number. There appears to be a linear relationship between dosage consumed and blood level two hours after ingestion. In addition signs and symptoms relate to blood Salicylate level. The effects of Salicylates on physiological systems is discussed. The current principles of treatment for Salicylate overdose are presented.

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.