Title: Highlights from the new Salicylate Toxicity Management Guideline
题目：2013年水杨酸中毒处理指南
Author 作者: Bryan Hayes

In June 2013 the American College of Medical Toxicology (ACMT) released a Guidance Document on the Management Priorities in Salicylate Toxicity. Here are some key highlights:
美国医学毒理学学院（ACMT）在2013年6月发布了如何处理水杨酸中毒的指南文件。下面是一些要点：
Continuous IV infusion of sodium bicarbonate is indicated even in the presence of mild alkalemia from the early respiratory alkalosis.
即使在早期由呼吸性碱中毒造成的碱血症情况下，也要持续静脉滴注 碳酸氢钠。
Euvolemia is important.
容量平衡很重要。
If intubation is required, administration of sodium bicarbonate by IV bolus at the time of intubation in a sufficient quantity to maintain a blood pH of 7.45-7.5 over the next 30 minutes is a reasonable management option during this critical juncture.
如果需要插管，在插管时要静脉推注足够量的碳酸氢钠使其能够在接 下来的30分钟内保持血液pH值7.45-7.5。这是在这种关键情况的一 个合理的处理方案。
Once airway control has been established, it is imperative that the increased minute ventilation and low PCO2 usually seen with salicylate intoxication are maintained.
一旦气道控制已经建立，要注意维持水杨酸中毒时常见的高每分钟通气量和低二氧化碳分压。
A salicylate concentration approaching 100 mg/dL warrants consideration of hemodialysis in the acute toxicity setting (40 mg/dL for chronic toxicity). Consult nephrology well before these threshold levels.
在急性中毒时，如水杨酸浓度接近100毫克/分升，要积极考虑血液透析（慢性中毒为40 mg / dL）。要在水平达到这些阈值前请肾脏科 会诊。
Reference 参考文献：
Guidance Document: Management Priorities in Salicylate Toxicity
http://www.acmt.net/cgi/page.cgi/zine_service.html?aid=4210&zine=show