41 of those 56 patients survived (73.2%). Lack of association with salicylate intoxication.Patents were included if salicylate levels >50mg/dl.Patients of all ages recorded as having ingested salicylate and salicylate containing medications resulting in intubation.Of those cases, investigators noted which patients received hemodialysis as part of their management.Identified cases of salicylate toxicity (level >50 mg/dl) from the Illinois Poison Center associated with the National Poison Data System (NPDS) treatment code of ASPIRIN and INTUBATION.Hemodialysis is another option in management of salicylate toxicity to help correct acid-base abnormalities and directly remove salicylates from the blood stream. In addition to ventilation management, other therapeutic options to help manage acute salicylate toxicity include alkalization of the serum to prevent conversion of salicylates to its non-ionized form, which easily crosses the blood brain barrier and can lead to cerebral edema and end organ damage. Despite this, intubation in many cases of severe salicylate toxicity is necessary. Once intubated, the peri-intubation minute ventilation, typically, cannot be matched by the ventilator, thus taking away the patient’s physiologic mechanism of compensation for the metabolic abnormalities associated with salicylate toxicity leading to further clinical deterioration. Patients with tachypnea are able to compensate for the profound metabolic acidosis that can develop from salicylate poisoning. Intubation has unique implications in patients with acute salicylate toxicity. As the severity of toxicity increases, the need for airway protection through intubation and mechanical ventilation becomes more profound. This is then followed by an anion gap metabolic acidosis.ĭue to the metabolic derangements induced by salicylates as well as salicylate’s direct stimulation on the respiratory centers of the brain, patients can present with profound tachypnea, fever and even altered mental status. Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. They are readily available, and in the setting of an overdose, can be fatal. Background: Salicylates are common substances that can be purchased over the counter.
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