Alkaline Diuresis in Treatment of Aspirin Poisoning

Publisher Website
Google Scholar
Abstract
The treatment of aspirin poisoning by the administration of NaHCO3 is not widely practised because of the possible deleterious effects of raising blood pH. This paper discusses the possible advantages in the production of an alkaline diuresis by the administration of fluids and NaHCO3 and describes the treatment in 5 cases of aspirin poisoning. Intravenous administration of dextrose, NaCl, and NaHCO3 solutions produced an average urine-flow of 6.9 ml/minute at mean pH of 7.5. This treatment resulted in a diminution of the serum salicylate to one-half of its original value in a mean time of 7.5 hours. The clinical signs in patients with severe aspirin poisoning who are seen early offer little prognostic assistance, and the value of the various clinical signs is discussed. Blood pH was increased to a mean value of 7.51 and no untoward effects were noted, all the patients recovering without incident. Blood K concentrations fell during treatment from a mean of 5.1 to 3.2 mEq/1. The serum salicylate concentration at the beginning of treatment may be misleadingly low, and a method is suggested for the interpretation of results. Five were patients studied in detail. Ten other cases were successfully treated, but the biochemical data are incomplete in these and are not recorded. A delayed onset of diuresis may be successfully treated with intravenous chlorothiazide. This observation is not, however, fully documented and is reported only tentatively.

This publication has 7 references indexed in Scilit: