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Critical Care Toxicology pp 1–17Cite as

Salicylates

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Abstract

Salicylate intoxication carries significant morbidity and mortality that are compounded when the seriousness of the situation is not recognized by the treating physician [1]. Progressive central nervous system (CNS) depression demands several immediate, aggressive actions, not just endotracheal intubation and ventilation. A small decrease in arterial pH to 7.3 may be of little consequence to most patients in a critical care unit, but in patients with salicylate intoxication, this decrease may result in rapid shifts of salicylate into the brain and heart, causing surprisingly swift deterioration and death. A decrease in serum drug concentrations is accompanied by clinical improvement in most other drug intoxications, but this frequently is not the case with serious salicylate poisoning. Patients may deteriorate and die as serum salicylate levels decrease.

Keywords

  • Methyl Salicylate
  • Control Mechanical Ventilation
  • Respiratory Alkalosis
  • Serum Glucose Concentration
  • Central Nervous System Dysfunction

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Author information

Authors and Affiliations

  1. Department of Medical Toxicology, Banner-University Medical Center Phoenix, Phoenix, AZ, USA

    Steven C. Curry

  2. Medical Toxicology, Banner Good Samaritan, Phoenix, AZ, USA

    Meghan B. Spyres

Authors
  1. Steven C. Curry
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  2. Meghan B. Spyres
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Correspondence to Steven C. Curry .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Curry, S.C., Spyres, M.B. (2015). Salicylates. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_11-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_11-1

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