Blood lactate and ketone body concentrations in salicylate intoxication

Blood concentrations of lactate, ketone bodies and non-esterified (free) fatty acids were measured in 45 adult patients on admission to the poisoning treatment centre, with salicylate and mixed salicylate-sedative/ethanol poisoning. Nine patients had blood lactate concentrations above 2 mmol/l and six patients had ketone-body concentrations greater than 1 mmol/l. Eight of the nine patients with hyperlactacidaemia had mixed salicylate/ethanol or sedative poisoning, whereas four of the six patients with hyperketonaemia had pure salicylate poisoning. No direct correlation was found between the presence of these metabolic disturbances and the severity of poisoning. Since only one patient was found with organic acid concentration in the blood exceeding 5 mmol/l, it is concluded that concomitant endogenous acidosis rarely contributes to the acid-base disturbance seen in salicylate poisoning in adults.