S. Tenney, R. Miller
Oct 1, 1955
Citations
1
Influential Citations
104
Citations
Quality indicators
Journal
The American journal of medicine
Abstract
Abstract 1.1. Sodium salicylate has a direct respiratory stimulant action. The locus of this effect is in the medulla and is independent of the aortic and carotid chemoreceptor areas. 2.2. Sodium salicylate also is a profound metabolic stimulant and may increase oxygen consumption two-fold. A dosage-response relationship has been established in dogs, the maximum effect being noted at dosages of about 100 mg./kg. when the drug is given intravenously. The source of metabolic increase is primarily skeletal muscle and is independent of the central and peripheral nervous system. It is also not dependent on epinephrine release. 3.3. In normal man prolonged salicylate administration increases the "sensitivity" of the respiratory center to carbon dioxide. 4.4. The principal change in acid-base balance in the intact dog and adult human is the development of respiratory alkalosis. When ventilation is inadequate, respiratory acidosis may develop. A diagram is presented to illustrate and differentiate the combined actions of salicylate on the respiratory mechanism—direct stimulation and secondary stimulation via increase in level of metabolism. 5.5. The circulatory system meets the increased level of oxygen consumption by widening the auriculoventricular oxygen difference and increasing cardiac output. There is an initial rise in systemic pressure, which usually returns to normal within fifteen minutes. Right ventricular pressure rises early and remains high for at least one hour. The magnitude of rise is directly proportional to the increase in cardiac output. The initial pressure rise is not caused by epinephrine release and can also be demonstrated in the presence of ganglionic blockage (tetraethyl ammonium chloride). It is concluded that this is a direct cardiac muscle effect of salicylate.