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Intoxicação por salicilato

Last reviewed: 14 Sep 2025
Last updated: 22 Mar 2024

Summary

Definition

History and exam

Key diagnostic factors

  • ingestão de 150 mg/kg ou mais, ou de 6.5 g ou mais, de aspirina ou equivalente
  • ingestão de salicilato de metila (óleo de gaultéria)
  • ingestão de subsalicilato de bismuto
  • lesão autoprovocada ou tentativa de suicídio
  • crianças com 3 ou menos anos de idade e adultos com 70 ou mais anos de idade
  • ingestão ou exposição a uma toxina desconhecida
  • comportamento anormal
  • náuseas, vômitos, hematêmese, dor epigástrica
  • febre e diaforese
  • dispneia
  • taquipneia, respiração de Kussmaul
  • zumbido e/ou surdez
  • mal-estar e/ou tontura
  • distúrbios do movimento, asterixis (flapping), estupor
  • confusão e/ou delirium (irritabilidade, alucinações)
  • coma e/ou papiledema
  • convulsões
  • estertores associados a baixa saturação de oxigênio
Full details

Other diagnostic factors

  • depleção de volume
  • erupção cutânea
Full details

Risk factors

  • ingestão de 150 mg/kg ou mais, ou de 6.5 g ou mais, de aspirina ou equivalente
  • ingestão de salicilato de metila (óleo de gaultéria)
  • ingestão de subsalicilato de bismuto
  • história de lesão autoprovocada ou tentativa de suicídio
  • crianças com 3 ou menos anos de idade e adultos com 70 ou mais anos de idade
Full details

Diagnostic investigations

1st investigations to order

  • gasometria arterial
  • painel de eletrólitos séricos
  • nível de salicilato sérico
  • ureia e creatinina séricas
  • cetonas séricas
  • glicose sanguínea
  • Hemograma completo
  • testes séricos da função hepática
  • tempo de protrombina (TP) sérico, tempo de tromboplastina parcial (TTP) ativada, razão normalizada internacional (INR)
  • análise toxicológica
  • radiografia torácica
  • eletrocardiograma (ECG)
Full details

Investigations to consider

  • ecocardiograma
  • tomografia computadorizada (TC) de crânio
  • eletroencefalograma (EEG)
Full details

Treatment algorithm

ACUTE

assintomático: sem critérios para o encaminhamento ao hospital

assintomático: com critérios para o encaminhamento ao hospital

pacientes sintomáticos

Contributors

Authors

Chris Hoyte, MD

Medical Toxicology Fellowship Program Director

Rocky Mountain Poison and Drug Safety

Denver

Professor

Department of Emergency Medicine

University of Colorado School of Medicine

Aurora

CO

Disclosures

CH declares that he has no competing interests.

Eric Lavonas, MD, MS

Attending Physician

Department of Emergency Medicine and Rocky Mountain Poison and Drug Safety

Denver Health

Denver

Professor

Department of Emergency Medicine

University of Colorado School of Medicine

Aurora

CO

Disclosures

EL is an author of a reference cited in this topic.

Acknowledgements

Dr Chris Hoyte and Dr Eric Lavonas would like to gratefully acknowledge Dr Kathryn A. Koch, a previous contributor to this topic. KAK declares that she has no competing interests.

Peer reviewers

Colin A. Graham, MBChB, MPH, MD, FRCSEd, FRCSGlasg, FIMCRCSEd, FCCP, FCEM, FHKCEM, FHKAM

Editor

European Journal of Emergency Medicine

Professor of Emergency Medicine

Chinese University of Hong Kong

Hong Kong

People's Republic of China

Disclosures

CAG is the editor of the European Journal of Emergency Medicine and receives an annual honorarium from Wolters Kluwer Health, the journal's publishers.

Gerald F. O'Malley, DO

Director

Division of Research

Department of Emergency Medicine

Albert Einstein Medical Center

Philadelphia

PA

Disclosures

GFOM declares that he has no competing interests.

Paul Wax, MD

Clinical Professor of Surgery (Emergency Medicine)

University of Texas Southwestern Medical Center

Dallas

TX

Disclosures

PW is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Palmer BF, Clegg DJ. Salicylate toxicity. N Engl J Med. 2020 Jun 25;382(26):2544-55. Abstract

Chyka PA, Erdman AR, Christianson G, et al. Salicylate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2007;45(2):95-131.Full text  Abstract

American College of Medical Toxicology. Guidance document: management priorities in salicylate toxicity. J Med Toxicol. 2015 Mar;11(1):149-52.Full text

Dargan PI, Wallace CI, Jones AL. An evidence based flowchart to guide the management of acute salicylate (aspirin) overdose. Emerg Med J. 2002 May;19(3):206-9.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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