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.