Recommendations for starting hemodialysis in salicylate toxicity

3.5 out of 5 stars Extracorporeal Treatment for Salicylate Poisoning: Systematic Review and Recommendations From the EXTRIP Workgroup. Juurlink D et al. Ann Emerg Med 2015 May 8 [Epub ahead of print] Abstract Aspirin is an especially dangerous poison for a number reasons: • It’s easy to purchase over-the-counter in large quantities • Even after a life-threatening acute ingestion of salicylate, a patient can present looking deceptively stable only to deteriorate catastrophically several hours later • In chronic salicylate toxicity, the diagnosis can be easily missed Ask many toxicologists about the poisons they fear the most, and aspirin will — more often than not — be high on the list. This paper, from the Extracorporeal Treatments in Poisoning (ExTRIP) workgroup, reviewed the literature on salicylate toxicity to determine evidence- and consensus-based recommendations on indications for use of extracorporeal treatment (essentially hemodialysis) in these cases. The emphasis, as in the group’s papers on other poisons, is on consensus rather than evidence, since the group has consistently found that the level of evidence for use of hemodialysis in any poisoning is very poor, amounting to — their words, not mine — “just a guess.” All of the recommendations presented here are rated as 1D — “1” representing a “strong recommendation,” “D” indicating that it is based on a “very low level of evidence.&...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical aspirin enhanced elimination extracorporeal treatment extrip hemodialysis indications salicylate toxicity Source Type: news