Salicylate-Induced Pulmonary Edema

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Abstract
To assess the course and prognosis of salicylate-induced pulmonary edema, the records of 36 consecutive patients admitted with serum salicylate levels > 30 mg/dl were reviewed. Pulmonary edema developed in 8 patients and pulmonary infiltrates were not seen in 28 patients. Several features distinguished the 2 patient groups. Persons with pulmonary edema were older, ingested salicylates chronically and had a history of smoking. They also were more likely to have neurologic abnormalities, proteinuria and serum salicylate levels > 40 mg/dl. The severity of pulmonary edema ranged from moderate (no assisted ventilation) to severe (characteristics of adult respiratory distress syndrome requiring assisted ventilation with positive end expiratory pressure). Pulmonary edema resolved concomitant with a decline in serum salicylate levels. Certain patients are at increased risk for salicylate pulmonary edema which responds to measures that lower serum salicylate levels.