Reversal of salicylate-induced euglycemic delirium with dextrose.
Salicylate poisoning inhibits Krebs cycle enzymes and uncouples oxidative phosphorylation. Under these circumstances, we hypothesize that CNS glucose supply is sometimes unable to keep up with demand resulting in hypoglycorrhacia and delirium even in the face of serum euglycemia. Supporting this conjecture, we report two euglycemic patients with salicylate-induced delirium who responded to boluses of concentrated dextrose with a prompt improvement in mental status.
Kuzak
Nick
N
Department of Emergency Medicine and Anesthesia, University of British Columbia, Vancouver, British Columbia, Canada. nickkuzak@hotmail.com
Brubacher
Jeff R
JR
Kennedy
James R
JR
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003693:Delirium / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D012459:Salicylates / Q000097:blood / Q000506:poisoning*
D001786:Blood Glucose; D012459:Salicylates; D005947:Glucose