PEDIATRICS Vol. 1 No. 4 April 1948, pp. 495-504
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SALICYLATE TOLERANCE AND TOXICITY IN CHILDREN

EMANUEL DUBOW M.D.1 and NATHANIEL H. SOLOMON M.D.1

1 The Pediatric Service of Dr. Philip Cohen, Beth Israel Hospital, New York City.

1. Twenty patients were given varying dosage of salicylate with the following results:

A. Dosage of 0.15 gm./kg. daily resulted in salicylate intoxication in the majority of patients between 4 and 11 years of age.

B. Dosage of 0.10 gm./kg. failed to attain what is generally considered to be optimal therapeutic blood salicylate levels.

C. With sodium salicylate dosage of 0.125 gm./kg., therapeutic blood levels of salicylate could be maintained for long periods of time without salicylate intoxication.

2. Acetylsalicylic acid appeared to be more toxic than sodium salicylate especially since, in equal weights, it supplies only 4/5 as much salicylate as sodium salicylate does.

3. Infants and children under three years of age failed to develop therapeutic plasma levels with dosage of sodium salicylate up to 0.15 gm/kg.

4. Hyperpnea, anorexia, apathy and lassitude are the important early signs of salicylate intoxication in children.

5. Blood pH values should be a determining factor in deciding whether alkali is to be administered therapeutically in salicylate poisoning.

6. Infectious diseases, dehydration and impaired renal function are important considerations in the production and treatment of salicylate intoxication.

Submitted on January 8, 1948