Patients with severe salicylate poisoning may require endotracheal intubation due to fatigue from hyperventilation or mental status change.
A previously published study (Stolbach et al. 2008) showed that mechanical ventilation increases the risk of acidemia and clinical deterioration.
A small retrospective study investigated the impact of hemodialysis (HD) in intubated patients with salicylate poisoning.
Findings:
53 cases with overall survival rate of 73.2%
In patients with salicylate level > 50 mg/dL
No HD: 56% survival (14/25)
HD: 83.9% survival (0/9)
If salicylate level > 80 mg/dL
No HD: 0% survival (26/31)
HD: 83.3% survival (15/18)
Bottom Line:
There is moratality benefit of HD in intubated salicylate-poisoned patient.
References
McCabe DJ, Lu JJ. The association of hemodialysis and survival in intuated salicylate-poisoned patients. Amer J Emerg Med 2017;35:899-903.
Stolbach QI, Hoffman RS, Nelson LS. Mechanical ventilation was associated with acidemia in a case series of salicylate-poisoned patients. Acad Emerge Med 2008;15;866-869.
