CONCLUSION
In the light of the previous results, the use of high dose ascorbic acid (VC) infusion in a mixed population of critically ill patients with Transfusion Related Acute Lung Injury “TRALI” was associated with significantly reduced oxidative stress, reduced pro-inflammatory markers except IL-1β, elevated anti-inflammatory marker, and elevated plasma VC levels. Although it failed to show 28-days mortality benefit, it was associated with better oxygenation, less vasopressor use, and improved 7-days mortality. This short-term mortality benefit is supposed to be via enhanced levels of serum IL-10.
Firstly, we recommend more research about TRALI, especially in developing countries. Further larger studies are recommended to enlighten research community the benefits of high dose ascorbic acid with TRALI, best time to administer, and the exact dose regimen. Failure to show 28-days mortality benefit may reflect the need of longer treatment with ascorbic acid beyond 96 hours. Targeting IL-10 in such patients is also recommended for further research.