Vitamin C Infusion for Treatment in Sepsis Induced Acute Lung Injury

Inclusion Criteria: * Patients must have suspected or proven infection, and meet 2 out of 4 of the criteria for Systemic Inflammatory Response (SIRS) due to infection, and be accompanied by at least 1 criterion for sepsis-induced organ dysfunction, and meet all 5 criteria for Acute Respiratory Distress Syndrome (ARDS). * Suspected or proven infection: (e.g., thorax, urinary tract, abdomen, skin, sinuses, central venous catheters, and central nervous system, see Appendix A). * The presence of a systemic inflammatory response: Defined as: fever: \>38ºC (any route) or hypothermia: \<36ºC (core temp only), tachycardia: heart rate \> 90 beats/min or receiving medications that slow heart rate or paced rhythm, leukocytosis: \>12,000 WBC/µL or leukopenia: \<4,000 WBC/µL or \>10% band forms. Respiratory rate \> 20 breaths per minute or PaCO2 \< 32 or invasive mechanical ventilation. * The presence of sepsis associated organ dysfunction: (any of the following thought to be due to infection) * Sepsis associated hypotension (systolic blood pressure (SBP) \< 90 mm Hg or an SBP decrease \> 40 mm Hg unexplained by other causes or use of vasopressors for blood pressure support (epinephrine, norepinephrine, dopamine =/\> 5mcg, phenylephrine, vasopressin) * Arterial hypoxemia (PaO2/FiO2 \< 300) or supplemental O2 \> 6LPM. * Lactate \> upper limits of normal laboratory results * Urine output \< 0.5 ml/kg/hour for \> two hours despite adequate fluid resuscitation * Platelet count \< 100,000 per mcL * Coagulopathy (INR \> 1.5) * Bilirubin \> 2 mg/dL * Glasgow Coma Scale \< 11 or a positive CAM ICU score * ARDS characterized by all the following criteria * Lung injury of acute onset, within 1 week of an apparent clinical insult and with progression of respiratory symptoms * Bilateral opacities on chest imaging not explained by other pulmonary pathology (e.g. pleural effusions, lung collapse, or nodules) * Respiratory failure not explained by heart failure or volume overload * Decreased arterial PaO2/FiO2 ratio ≤ 300 mm Hg * Minimum PEEP of 5 cmH2O (may be delivered noninvasively with CPAP to diagnose mild ARDS Exclusion Criteria: * Known allergy to Vitamin C * inability to obtain consent; * age \< 18 years; * No indwelling venous or arterial catheter in patients requiring insulin in a manner that requires glucose being checked more than twice daily (e.g. continuous infusion, sliding scale); * presence of diabetic ketoacidosis; * more than 48 hrs since meeting ARDS criteria; * patient or surrogate or physician not committed to full support (not excluded if patient would receive all supportive care except for cardiac resuscitation); * pregnancy or breast feeding, * moribund patient not expected to survive 24 hours; * home mechanical ventilation (via tracheotomy or noninvasive) except for CPAP/BIPAP used only for sleep-disordered breathing; * home O2 \> 2LPM, except for with CPAP/BIPAP * diffuse alveolar hemorrhage (vasculitis); * interstitial lung disease requiring continuous home oxygen therapy; * Active kidney stone * Non English speaking; * Ward of the state (inmate, other)