Hemodialysis and the intubated salicylate-toxic patient

3.5 out of 5 stars The association of hemodialysis and survival in intubated salicylate-poisoned patients. McCabe DJ, Lu JJ. Am J Emerg Med 2017 Apr 10 [Epub ahead of print] Abstract [Disclosure: the co-authors of this paper are members of the Toxikon Consortium in Chicago, as am I.] This retrospective observational study looked at cases from the Illinois Poison Center over 12 years (2003 thru 2015) to identify intubated patients with recorded serum salicylate levels > 50 mg/dL. The goal was “to describe the impact of hemodialysis on survival rates of salicylate-intoxicated patients . . .” The authors identified 64 patients. Eight patients were excluded because of “clear lack of association [of intubation] with salicylate intoxication.” The remaining 56 patients were analyzed. Of the 31 patients who received hemodialysis, 4 (13%) died; of the 25 patients who did not receive HD, 11 ( 44%) died. No patient required intubation after hemodialysis was initiated. The authors’ conclusion: “In salicylate-poisoned patients who required mechanical ventilation emergent hemodialysis is associated with a mortality benefit.” They suggest that it is reasonable to recommend prompt hemodialysis for all intubated salicylate overdose patients. We’ve discussed previously the problems inherent in analyzing computerized poison center data, including lack of complete clinical data, inability to establish causation rather than mere association...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical aspirin poisoning enhanced elimination hemodialysis salicylate toxicity Source Type: news