Department of Emergency Medicine

UMEM Educational Pearls

Title: Salicylate Serum Concentrations - Be Wary

Category: Toxicology

Keywords: Salicylate, aspirin, metabolic acidosisM (PubMed Search)

Posted: 7/17/2008 by Fermin Barrueto (Updated: 3/6/2026)
Click here to contact Fermin Barrueto

  •  Therapeutic concentration considered 10-20 mg/dL
  •  Some hospitals report in "mg/L" thus a level of 110 mg/L is therapeutic
  •  Symptoms of Toxicity usually > 40 mg/dL
  •  Consider Hemodialysis in any patient with a serum concentration >100 mg/dL

First Line Therapy:  Urine Alkalinization (pH >7.5) by administrating NaHCO3

Other Indications for Hemodialysis in Salicylate Poisoned Patient:

  1. Renal Failure
  2. CHF
  3. Acute Lung Injury
  4. Persistent CNS disturbances
  5. Refractory metabolic acidosis or electrolyte abnormality
  6. Hepatic insufficiency with coagulopathy

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