The Repurposing of Lidocaine for the Prevention and Treatment of Acute Lung Injury: An Integrative Review.
This integrative review evaluated current evidence on the use of lidocaine for the prevention and treatment of inflammation secondary to pulmonary aspiration of gastric contents. A comprehensive search of CINAHL, PubMed, and Embase was conducted for English-language studies published between 2014 and 2025, with the final search completed on May 5, 2025. Eligible studies included animal, human, and in vitro research that investigated the anti-inflammatory effects of intravenous lidocaine treatment for acute lung injury. Exclusion criteria were non-English publications, case reports, and studies that took place prior to 2014. Lidocaine appears to mitigate inflammatory lung injury through several mechanisms: antagonism of the P2X7 receptor, upregulation of SOCS3 protein, reduction of reactive oxygen species, and inhibition of NETosis. These effects contribute to a decrease in the inflammatory cascade following aspiration events. As research continues to expand the understanding of the different clinical applications of lidocaine, it may demonstrate promise in the prevention and treatment of pulmonary aspiration. Clinical judgment should always be used to assess patient-specific factors and ensure safe administration. Reliance on in vitro and animal studies limit the results of this review to be generalized to human subjects, therefore future research should be more inclusive of human trials.