Vitamin C Infusion for Gastric Acid Aspiration-Induced Acute Respiratory Distress Syndrome (ARDS).
Massive pulmonary gastric acid aspiration uniformly produces very severe, acute lung injury. At present there is no know interventional therapy for aspiration-induced acute lung injury. Emergent therapeutic approaches in the past have included careful volume limited mechanical ventilatory support along with appropriate critical care measures such as careful fluid management, vasopressor support, and broad spectrum antibiotics.
Increasingly, extracorporeal membrane oxygenation is being employed to support patients following the onset of acute
respiratory distress syndrome induced by a number of acute illnesses.
Here we describe the first use of high dosage intravenous vitamin C as an adjunctive measure to decrease the intensity of lung injury suffered in a patient following high volume gastric acid aspiration that rapidly led to ARDS.
A 34-year-old male experienced a witnessed generalized tonic clonic seizure and gastric aspiration followed by 3 minutes of cardiopulmonary resuscitation for pulseless electrical activity arrest.
The patient’s past medical history was significant for attention deficit/hyperactivity disorder, gastro-esophageal reflux
disease, hypothyroidism and chronic lower back pain. There was no known history of seizure disorder. Postictal and post-return of spontaneous circulation, the patient was restless but following commands. The patient was normotensive.
The cardiac exam revealed a regular tachycardia with no murmurs, gallops or rubs. No jugular venous distension was present. Chest exam revealed diffuse rhonchi bilaterally with diminished air movement. Blood was present in the mouth and nares.
Pulm Res Respir Med Open J. 2017; 4(2): 33-37. doi: 10.17140/PRRMOJ-4-136
