Which acid-base disorder is typically seen in salicylate toxicity?

In salicylate toxicity, respiratory alkalosis is typically observed due to overstimulation of the respiratory center in the brain by salicylates. This stimulation leads to hyperventilation, resulting in excessive elimination of carbon dioxide (CO2) from the body, which elevates blood pH and creates an alkalotic state.

As salicylate levels rise, they can cause both a primary respiratory alkalosis and a metabolic acidosis due to the accumulation of organic acids, such as lactate, which may contribute to the acid-base disturbances observed. However, the initial and predominant effect seen with salicylate overdose is respiratory alkalosis, arising from that hyperventilation response.

This phenomenon is an important consideration in the management of patients with suspected salicylate poisoning, making it crucial for emergency providers to recognize these hallmark changes in order to properly assess and treat the condition.