What is the net acid-base disturbance typically seen in salicylate overdose?

What is the net acid-base disturbance typically seen in salicylate overdose?

• A. Mixed Respiratory Alkalosis + Metabolic Acidosis
• B. Metabolic Acidosis only
• C. Respiratory Alkalosis only
• D. Metabolic Alkalosis

Answer: (A)

In salicylate overdose two processes happen at once, creating a mixed acid-base picture. The drug stimulates the respiratory center, so the patient hyperventilates and blows off CO2, producing a respiratory alkalosis. At the same time, salicylates disrupt cellular energy and promote the formation of organic acids like lactate, leading to a high anion gap metabolic acidosis. Because both disturbances occur together, the arterial blood gas often shows a low CO2 and a low bicarbonate, with the pH that may be near normal or only mildly acidotic. This combination—respiratory alkalosis plus metabolic acidosis—is the typical net disturbance in salicylate overdose.

In salicylate overdose two processes happen at once, creating a mixed acid-base picture. The drug stimulates the respiratory center, so the patient hyperventilates and blows off CO2, producing a respiratory alkalosis. At the same time, salicylates disrupt cellular energy and promote the formation of organic acids like lactate, leading to a high anion gap metabolic acidosis. Because both disturbances occur together, the arterial blood gas often shows a low CO2 and a low bicarbonate, with the pH that may be near normal or only mildly acidotic. This combination—respiratory alkalosis plus metabolic acidosis—is the typical net disturbance in salicylate overdose.