Vitamin C Infusion for Gastric Acid Aspiration-Induced Acute Respiratory Distress Syndrome (ARDS)
Journal Title: Pulmonary Research and Respiratory Medicine – Open Journal - Year 2017, Vol 4, Issue 2
Abstract
Introduction Gastric acid aspiration into the lung has long been established as a direct cause of acute lung injury that rapidly leads to a clinical diagnosis of acute respiratory distress syndrome (ARDS). Gastric juices contain a low pH liquid and frequently mouth organisms. When aspiration of gastric liquid into the lower airway occurs, a caustic injury to the lower airway and distal airspaces occurs. The acute inflammatory events that occur following gastric acid aspiration induce injury by direct lung tissue toxicity.1 As well, acute adhesion of activated blood neutrophils throughout the pulmonary microcirculation and the subsequent migration of activated cells into the alveolar space rapidly induces acute injury to the alveolar capillary membrane with subsequent rapid loss of lung barrier function. Virtually always acute lung injury of the magnitude described in the case we report here occurs, producing ARDS. Thus far, no therapy has reliably proven effective for gastric acid-induced ARDS. Case Presentation In this report, we describe the onset of acute respiratory failure with rapid onset ARDS in a 34-year-old patient who experienced a generalized tonic-clonic seizure followed by witnessed vomiting and aspiration of gastric contents following a morning meal. The patient rapidly developed acute respiratory failure, necessitating mechanical ventilation. Ventilatory support failed to oxygenate or ventilate the patient. Extracorporeal membrane oxygenation was instituted. Vitamin C was infused intravenously at 50 mg/kg every 6 hours starting on hospital day 2 with subsequent significant improvement in lung function and lung imaging. Conclusion This report adds to the increasing clinical experience employing high dosages of intravenous vitamin C to attenuate the acute inflammatory lung injury. If further adds to the experience of using extracorporeal membrane oxygenation to support lung injured patients.
Authors and Affiliations
Alpha A. Fowler, III
Keywords
Related Articles
- EP ID EP546196
- DOI 10.17140/PRRMOJ-4-136
- Views 170
- Downloads 0
Diaphragm Ultrasonography as a Tool To Assess the Respiratory Issues of a Patient With Amyotrophic Lateral Sclerosis (ALS)
A 73-year-old woman with Amyotrophic Lateral Sclerosis (ALS) presented at a universityaffiliated community hospital with increasing shortness of breath. She was diagnosed with ALS 2 years prior to this event, and she had...
Consistency of Interpretation of Lung Sounds between Experienced Physicians and Automatic Analysis Using a Newly Developed Algorithm Based on the Acoustic Characteristics
Background: Listening and interpreting lung sounds by a stethoscope has been an important component of screening and diagnosing lung diseases. However, this practice is vulnerable to inter-observer variations and difficu...
Biomarkers for Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease (COPD): What is the Role of microRNAs?
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous respiratory disease characterized by a progressive, not fully reversible airflow limitation associated with an abnormal inflammatory response of the lungs t...
Balloon Pulmonary Angioplasty (BPA) and Rehabilitation for Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
Chronic thromboembolic pulmonary hypertension (CTEPH) has a poor prognosis because of increased pulmonary arterial pressure (PAP) causing pulmonary hypertension and progressive right-sided heart failure.1,2 Typical sympt...
Pneumocystis Carinii Pneumonia; Lost Lives in Pregnancy: Chemoprophylaxis Saves Lives
The advent of HIV/AIDS brought opportunistic infections such as Pneumocystis jiroveci pneumonia (PJP), formerly known as Pneumocystis carinii pneumonia (PCP) to the fore. This is a fungal opportunistic infection that is...