Acute salicylate poisoning

Mild or early aspirin or other salicylate poisoning manifests as a condition known as salicylism, which can develop over 6 to 12 hours. Effects include tinnitus, hearing impairment, dizziness, nausea and vomiting. This is associated with primary respiratory alkalosis. In more severe poisoning, metabolic acidosis and multiorgan dysfunction develop. The relationship between the dose ingested and toxicity is outlined in Dose-dependent toxic effects of acute aspirin ingestion.

Effects of acute salicylate poisoning by body system include:

• gastrointestinal effects—nausea, vomiting, epigastric pain
• central nervous system effects
  • tinnitus, hearing impairment, dizziness, agitation
  • altered conscious state, coma, seizures (severe toxicity)
• metabolic effects
  • primary respiratory alkalosis (early or mild to moderate toxicity)
  • mixed respiratory alkalosis and metabolic acidosis (evolving or moderate to severe toxicity)
  • mixed respiratory acidosis and metabolic acidosis (severe toxicity when hyperventilation is no longer able to compensate)
  • hypokalaemia, hypoglycaemia, hyperglycaemia with associated intracellular hypoglycaemia
  • hyperthermia
• haematological effects—mild coagulation abnormalities, antiplatelet effects
• other effects—pulmonary oedema, acute kidney injury.