Treatment of Metabolic Acidosis in Salicylate (Salicylic Acid) Poisoning
Metabolic acidosis arising from salicylate (salicylic acid) poisoning is a distinct clinical scenario in which the acid-base disturbance and the underlying toxicological cause are addressed together. Management in this context goes beyond routine acid-base correction.
Clinical scenario
Metabolic acidosis associated with salicylate (salicylic acid) poisoning. The toxicological origin of the acid-base disturbance is the defining feature that shapes the therapeutic strategy.
Treatment approach (partial overview)
Expert guidance supports the use of sodium bicarbonate — given regardless of the presenting pH value — as a cornerstone intervention. The complete sequencing and clinical decision algorithm are in the full protocol.
References
DOI: 10.1053/j.ajkd.2019.01.036
The experts suggest administering sodium bicarbonate in the therapeutic management of salicylate poisoning, whatever the pH value (EXPERT OPINION).
The aim of bicarbonate administration is twofold: induce alkalemia to limit the passage of salicylate into the central nervous system and alkalinization of urine to promote renal excretion of salicylate.
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