Adult respiratory distress syndrome precipitated by massive salicylate poisoning

Andersen, Rune; Refstad, Sverre

doi:10.1007/bf01902550

Cited by 13 publications

(3 citation statements)

References 7 publications

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“…It has been demonstrated that ARDS can be precipitated by massive salicylate poisoning (21,22). In five patients there were clinical and radiological signs of ARDS; two of the patients died.…”

Section: Respiratory Complicalionsmentioning

confidence: 99%

Acute salicylate self‐poisoning in 177 consecutive patients treated in ICU

Thisted

Krantz

Strøm

et al. 1987

Acta Anaesthesiol Scand

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The course of 177 consecutive patients with severe salicylate self-poisoning treated in an intensive care unit (ICU) during a period of 15 years is presented. On admission, cerebral depression was observed in 61% respiratory failure was present in 47%, acidosis in 36% and cardiovascular function was impaired in 14%. A mortality rate of 15% was observed, which was proportionally higher in patients more than 40 years old and in patients with delayed diagnosis. Twenty-seven patients died and an autopsy was performed on 26 patients. The main autopsy diagnosis was ulcers of the gastrointestinal tract in 46%, pulmonary oedema in 46%, cerebral oedema in 31% and cerebral haemorrhage in 23%.

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Section: Respiratory Complicalionsmentioning

confidence: 99%

Acute salicylate self‐poisoning in 177 consecutive patients treated in ICU

Thisted

Krantz

Strøm

et al. 1987

Acta Anaesthesiol Scand

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“…To explore this possibility we have investigated the effects of spontaneous hyperventilation in an animal model, using sodium salicylate (SS). SS is known to induce hyperventilation when ingested orally [5,12], or when infused directly into the cisterna magna [13].…”

mentioning

confidence: 99%

Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study

et al. 1988

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The pulmonary effects of hyperventilation following infusion of sodium salicylate into the cisterna magna was studied in 16 spontaneously breathing adult sheep. We found a fall in PaO2, a decrease in the static compliance of the respiratory system, abnormal chest roentgenographic films, and grossly abnormal lungs following 3.5 to 13 h of hyperventilation. A control group of 15 sheep (10 sheep similarly injected with sodium salicylate, but then sedated and paralyzed and ventilated at normal tidal volume and respiratory rate on a mechanical ventilator, and 5 sheep infused with saline alone and breathing spontaneously) showed no pulmonary or arterial blood gas abnormalities. We conclude that prolonged hyperventilation under the conditions of this experiment precipitated events that resulted in acute lung injury.

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“…Four case reports (level 4) were found with dose and effect information for acute-on-chronic aspirin toxicity in patients over 6 years of age (80,120,161,162). The lowest dose leading to toxicity involved a 54-year-old man who died after acutely ingesting 5,000-6,000 mg aspirin after taking 1,300-2,000 mg aspirin daily for weeks (120).…”

Section: Acute-on-chronic Exposuresmentioning

confidence: 99%

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

Chyka

Erdman

Christianson

et al. 2007

Clinical Toxicology

116

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American Association of Poison Control Centers, Washington, District of Columbia, USAA review of U.S. poison center data for 2004 showed over 40,000 exposures to salicylate-containing products. A guideline that determines the conditions for emergency department referral and pre-hospital care could potentially optimize patient outcome, avoid unnecessary emergency department visits, reduce health care costs, and reduce life disruption for patients and caregivers. An evidence-based expert consensus process was used to create the guideline. Relevant articles were abstracted by a trained physician researcher. The first draft of the guideline was created by the lead author. The entire panel discussed and refined the guideline before distribution to secondary reviewers for comment. The panel then made changes based on the secondary review comments. The objective of this guideline is to assist poison center personnel in the appropriate out-of-hospital triage and initial out-of-hospital management of patients with a suspected exposure to salicylates by 1) describing the process by which a specialist in poison information should evaluate an exposure to salicylates, 2) identifying the key decision elements in managing cases of salicylate exposure, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline is based on an assessment of current scientific and clinical information. The expert consensus panel recognizes that specific patient care decisions may be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all of the circumstances involved. This guideline does not substitute for clinical judgment. Recommendations are in chronological order of likely clinical use. The grade of recommendation is in parentheses: 1) Patients with stated or suspected self-harm or who are the victims of a potentially malicious administration of a salicylate, should be referred to an emergency department immediately. This referral should be guided by local poison center procedures. In general, this should occur regardless of the dose reported (Grade D).2) The presence of typical symptoms of salicylate toxicity such as hematemesis, tachypnea, hyperpnea, dyspnea, tinnitus, deafness, lethargy, seizures, unexplained lethargy, or confusion warrants referral to an emergency department for evaluation (Grade C). 3) Patients who exhibit typical symptoms of salicylate toxicity or nonspecific symptoms such as unexplained lethargy, confusion, or dyspnea, which could indicate the development of chronic salicylate toxicity, should be referred to an emergency department (Grade C). 4) Patients without evidence of self-harm should have further evaluation, including determination of the dose, time of ingestion, presence of symptoms, history of other medical conditions, and the presence of co-ingestants. The acute ingestion of more than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less, war...

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Adult respiratory distress syndrome precipitated by massive salicylate poisoning

Cited by 13 publications

References 7 publications

Acute salicylate self‐poisoning in 177 consecutive patients treated in ICU

Acute salicylate self‐poisoning in 177 consecutive patients treated in ICU

Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study

Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management

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