*Alkaline pH leads to the increase in the concentration of salicylate in the urine (up to 10 times when pH is increased from 7 to 8)
*It is indicated in moderate salicylate poisoning in absence of shock, heart failure and impaired renal function,
*It targets to achieve a urinary pH 8.0 -8.5.
*Plasma potassium deficit must be corrected to ensure that the alkalinity of urine is achieved without raising the plasma pH. This is achieved as follows:
**Infuse the following in the 1st hr: 500 mL 5% dextrose to prevent hypoglycaemia, 500mL sodium bicarbonate 1.4%, 500 mL dextrose 5% and Potassium chloride added (to maintain serum potassium of above 3.5 mmol/l).
**The above is followed by 1.5-2.0L of i.v. fluids / hr for 3 hrs and ensure the urine volume that is greater than 500mL/hr
**Monitor urine pH at 30-minute interval to maintain the pH at 7.5 - 8.5.
**Infuse at rate of 30mg/kg/hr in children