Specific Poisonings: Paracetamol and Salicylates
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Salicylate overdose initially causes respiratory alkalosis due to direct stimulation of the respiratory center in the medulla, leading to hyperventilation and decreased PaCO2. Later, a metabolic acidosis may develop due to accumulation of organic acids. The lab findings (high pH, low PaCO2, low HCO3-) are classic for a mixed respiratory alkalosis and metabolic acidosis, but early on, respiratory alkalosis predominates. The question describes early changes: high pH, low PaCO2, and low HCO3- (compensatory renal excretion of bicarbonate). This fits respiratory alkalosis with partial compensation.
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