High frequency jet ventilation and aspirin poisoning.

ASPIRIN poisoning is responsible for over 200 deaths per annum in England and Wales. Forced alkaline diuresis is advocated to hasten renal elimination of the drug when plasma salicylate levels exceed 500 mg/l, whilst charcoal haemoperfusion is the treatment of choice when plasma salicylate levels exceed 900 mg/kg.' This severity of poisoning causes gross respiratory, metabolic and coagulation disturbances, usually requiring cardiovascular and respiratory support.2 Conventional low frequency, high volume ventilation is known to impair venous return and cardiac output, so that if respiratory support is needed this type of ventilation may further compromise the cardiovascular system.3 4 High frequency jet ventilation (HFJV) is an effective means of controlling ventilation without impairing cardiac output and was successfully used in this case to support respiration in a hypotensive patient suffering from aspirin poisoning.5