Jan 1, 1975

Central nervous system salicylate

Clinical Toxicology
J R Reed, P A Palmisano


The poor correlation between clinical salicylate toxicity and serum blood levels is reapproached in light of recent evidence linking clinical severity with initial volume of distribution (Vd). It is recognized that two variables alter salicylate Vd in such manner that serum salicylate levels are misleading (thus, the change in Vd is not detected by present methods). These variables are serum protein binding and the pH-dependent ionized/un-ionized ratio in the unbound salicylate fraction. Measurements of salicylate concentration in the cerebro spinal fluid (CSF) would circumvent these variables, but would be clinically impractical. Thus, an alternative is sought to the inexact total serum salicylate levels and the impractical CSF salicylate levels for assessment of the severity of salicylate poisoning. This study indicates that, in dogs, serum unbound salicylate levels closely reflect CSF salicylate levels, even as a decrease in serum protein binding is in progress. However, serum unbound salicylate concentration does not reflect CSF salicylate concentration as a decrease in serum pH is elicited (CSF salicylate actually increased as serum unbound salicylate decreased). On the other hand, serum unbound salicylate measurement woul...Continue Reading

  • References3
  • Citations6


  • References3
  • Citations6


Mentioned in this Paper

Acetazolamide Sodium, (Sterile)
Serum Proteins
Plasma Protein Binding Capacity
CNS Disorder
Carbon Dioxide
Salicylic Acids
Hydrogen-Ion Concentration

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