Intravenous Vitamin C Administered as Adjunctive Therapy for Recurrent Acute Respiratory Distress Syndrome.
Intravenous Vitamin C Administered as Adjunctive Therapy for Recurrent Acute Respiratory Distress Syndrome.
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DOI：
10.1155/2016/8560871
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发表时间：
2016
影响因子：
--
通讯作者：
Fowler AA
中科院分区：
文献类型：
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作者：
Bharara A;Grossman C;Grinnan D;Syed A;Fisher B;DeWilde C;Natarajan R;Fowler AA
本病例报告总结了首次使用静脉维生素C作为连续性介入剂治疗复发性急性呼吸窘迫综合征（ARDS）。这两次ARDS发生在一名患有Cronkhite-Canada综合征的年轻女性患者中，Cronkhite-Canada综合征是一种罕见的、偶发的、非遗传性疾病，其特征是广泛的胃肠道息肉病和吸收不良。在脓毒症发作之前，患者通过长期中心静脉导管接受慢性高营养治疗。该患者出现革兰氏阳性球菌复发性脓毒症，导致两例ARDS。本报告描述了一位脓毒症合并急性呼吸衰竭患者的基础广泛的一般重症监护，包括液体复苏、广谱抗生素和血管加压素支持。静脉注射维生素C 50毫克每公斤体重每6小时，共96小时，作为一种预防剂，在照顾这个病人。维生素C当以高剂量用作胃肠外药剂时，起“多效性”作用以减弱促炎介质表达，改善肺泡液清除，并充当抗氧化剂。
This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter. The patient became recurrently septic with Gram positive cocci which led to two instances of ARDS. This report describes the broad-based general critical care of a septic patient with acute respiratory failure that includes fluid resuscitation, broad-spectrum antibiotics, and vasopressor support. Intravenous vitamin C infused at 50 mg per kilogram body weight every 6 hours for 96 hours was incorporated as an adjunctive agent in the care of this patient. Vitamin C when used as a parenteral agent in high doses acts “pleiotropically” to attenuate proinflammatory mediator expression, to improve alveolar fluid clearance, and to act as an antioxidant.