ABG: Salicylate toxicity

Salicylates inhibit the citric acid cycle and uncouple oxidative phosphorylation. Inhibition of these ATP-dependent processes results in:

1. Increased O₂ consumption
2. Increased CO₂ production
3. Enhanced glycolytic and lipolytic metabolism
4. Depletion of hepatic glycogen
5. Hyperpyrexia

Effects on Acid-Base Status

Effects of salicylate toxicity vary based on the dose and age of the patient. Direct stimulation of respiratory centers results in a respiratory alkalosis initially. In mild cases, this may be the only acid-base manifestation. Infants, however, rarely presents with mild cases. In severe cases, however, a dire metabolic (ketolactic) acidosis develops. There is a compensatory respiratory alkalosis and the development of a paradoxical aciduria.