A Case Series of Vaping-Induced Lung Injury in a Community Hospital Setting

Ali, M. Azam; Khan, Kiran Shafiq; Buch, Mihir; Ramirez, Manuel Ramos; Sharma, Manish; Patel, Seema; Choudhury, Saiara; Anjum, Humayun; Khan, Alamgir; Surani, Salim

doi:10.1155/2020/9631916

Cited by 14 publications

(8 citation statements)

References 8 publications

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“…Despite this, most of the cases of EVALI have been associated with the use of e-cigarettes containing THC, the concentrations of which can exceed that of dried cannabis by up to 30 times. According to the CDC, THC and vitamin E acetate, a condensing agent in vaping products that had been found in all injured lung fluid samples, may be the culprits of lung injury [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax secondary to vaping

Wieckowska

Assaad

Aboudan

2021

Respiratory Medicine Case Reports

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Pneumothorax is the presence of air in the pleural space that can result in the partial or complete collapse of a lung. Cigarette and cannabis smoking are also well-known risk factors. Vaping, on the other hand, is not as well-established as little is known about the impact electronic cigarettes have on the development of pneumothoraces despite their use rapidly increasing over the past decade. While the long-term adverse health effects of vaping are still unknown, the acute adverse events of vaping that have occurred are concerning. Pneumothoraces due to electronic cigarettes have been rarely reported so far but the body of literature illustrating an association is growing. We hope to contribute to it by presenting a case of a 19-year-old male who presented with an e-cigarette induced pneumothorax. It is our hope that this case brings more evidence to the dangers of e-cigarette use.

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Section: Discussionmentioning

confidence: 99%

Pneumothorax secondary to vaping

Wieckowska

Assaad

Aboudan

2021

Respiratory Medicine Case Reports

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“…These findings were present on admission, before the initiation of positive pressure or invasive ventilation. Air leak has been described in smaller case reports, 26‐28 but was not discussed in larger cohorts. The mechanism for this air leak is unclear but is reminiscent of the known increased risk of pneumothorax associated with traditional cigarette smoking 29 .…”

Section: Discussionmentioning

confidence: 99%

“…These findings were present on admission, before the initiation of positive pressure or invasive ventilation. Air leak has been described in smaller case reports, [26][27][28]…”

Section: Clinical Presentation and Risk Factorsmentioning

confidence: 99%

Characterizing e‐cigarette vaping‐associated lung injury in the pediatric intensive care unit

Reddy

Jenssen

Chidambaram

et al. 2020

Pediatric Pulmonology

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Objective Adolescent e‐cigarette use has risen to epidemic levels in the US, revealing a new phenomenon of e‐cigarette vaping‐associated lung injury (EVALI). It is important to better characterize EVALI in critically ill adolescents as this is a vulnerable and rapidly growing demographic. Methods This was a retrospective case series of patients ≤21 years old with confirmed or probable EVALI (as defined by the Centers for Disease Control) that resulted in admission to the pediatric intensive care unit (PICU) of a large tertiary academic children's hospital between August 2019 and January 2020. Results There were six eligible patients, with a median age of 17 years. All patients reported tetrahydrocannabinol as well as nicotine e‐cigarette use. Half of the patients had a preexisting diagnosis of asthma and four patients had mental health comorbidities. All patients presented with respiratory alkalosis and chest radiography showing diffuse bilateral infiltrates; two patients had pneumomediastinum, subcutaneous air and/or pneumothorax. The lowest documented ratio of oxygen saturation to inspired oxygen (SpO2:FiO2 or S/F ratio) ranged from 146 to 296. Two patients required an arterial line, with the lowest ratio of arterial oxygen to inspired oxygen (PaO2:FiO2 or P/F ratio) of 197 and 165. Two patients tested positive for rhinovirus and respiratory cultures were negative for all patients. Four patients underwent chest computed tomography imaging, which showed diffuse ground‐glass opacities. Every patient required noninvasive positive pressure ventilation, with one progressing to invasive ventilation. All patients received broad‐spectrum intravenous antibiotics and steroids, though there was considerable variability in dose, frequency, and duration of steroids. The hospital length of stay ranged from 5 to 16 days (median 8.3 days) with PICU length of stay ranging from 4 to 10 days (median 5.5 days). Four patients had pulmonary function testing before discharge, two of which showed decreased diffusing capacity of the lung for carbon monoxide. There were no patient deaths. Conclusions This single‐center case series describes the presentation, course, and treatment of EVALI in a pediatric intensive care unit setting. Our results show nuanced differences in the presentation and management of the critically ill adolescent, and raise many questions about the long term implications on lung health, morbidity, and mortality. Importantly, these cases illustrate the critical care consequences of a public health phenomenon and should spur further research and policy to address the negative health effects of vaping.

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“…Análise anatomopatológica foi realizada em 164 desses indivíduos, (material via broncoscopia) e achados mais frequentes: dano alveolar difuso, hemorragia 8 alveolar; pneumonia lipoide, proteinose alveolar e BOOP em alguns casos. 2,4,5,6,18,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49…”

Section: Fonte: Dados Coletados Pelos Autoresunclassified

“…Em 2017, 2,8% dos adultos norte-americanos eram usuários atuais de cigarros eletrônicos.Em 2015, entre os usuários adultos de cigarros eletrônicos em geral, 58,8% também eram fumantes regulares atuais, 29,8% eram ex-fumantes regulares e 11,4% nunca haviam sido fumantes regulares.Entre os usuários atuais de cigarro eletrônico com 45 anos ou mais em 2015, a maioria era fumante regular ou ex-fumante e 1,3% nunca havia fumado. Em contraste, entre os usuários atuais de cigarros eletrônicos com idade entre 18 e 24 anos, 40,0% nunca haviam fumado regularmente.3, 8,15,16, 17, 20,21,24,25,26, 27,63,64,65,66,67,68,69,70,71, 72,73, 74, 75,76, 77,78,79,80,81,82, 83,84, 85,86 …”

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Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

D’Almeida¹,

Silveira²,

Poiano³

et al. 2020

Blucher Medical Proceedings

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Vaping Associated Lung Injuries/Illnessess (lesões pulmonares/doenças pulmonares associadas ao cigarro eletrônico ou ao "vaping").Difundido pela indústria do tabaco como menos prejudicial à saúde, o cigarro eletrônico ganhou espaço entre jovens. Mas seu uso vem causando síndrome emergente, com manifestações clínicas importantes e até mesmo óbito. O diagnóstico é de exclusão. O tratamento é feito com cessação do uso do cigarro eletrônico e terapia empírica com corticóides, antimicrobianos e antivirais. OBJETIVO: Descrever as principais manifestações clínicas, radiológicas e anátomo patológicas em pacientes com EVALI. METODOLOGIA: Revisão narrativa sistematizada, em base de dados: Bireme, Cochrane Library, Pubmed e Scielo. Descritor utilizado: "Electronic Nicotine Delivery Systems" AND "Lung Injury". Selecionados publicações dos últimos dez anos (línguas inglesa, espanhola e portuguesa), sem restrição do tipo de estudo. 402 artigos incialmente; excluídos os repetidos em diferentes bases de dados e os que não se relacionavam ao tema ou se relacionavam com outras doenças. Por fim, 101 estudos foram utilizados. RESULTADOS: 2.668 relatos de pessoas com EVALI (até 14 janeiro 2020), média de idade 24 anos (13 a 85 anos); 66 % sexo masculino; Tempo médio de uso do cigarro eletrônico de 12,8 meses (variando de 1 dia a 5 anos de uso).Manifestações clínicas: dispneia (66,5%), tosse (64%), febre (60%), fadiga (40%) e dor torácica (35,5%). Sintomas gastrointestinais foram frequentes: vômitos (48%), náuseas (45%), diarréia (25%) e dor abdominal (19%). Cerca 25% dos pacientes apresentaram taquipneia e hipoxemia e 3,6% hemoptise. Manifestações radiológicas: infiltrado intersticial (vidro fosco) em mais de 90% dos casos e raramente consolidações, opacidades alveolares, lesões cavitárias e bronquiectasias. Análise anatomopatológica realizada em 164 desses indivíduos, (material via broncoscopia) e achados mais frequentes: dano alveolar difuso, hemorragia alveolar; pneumonia lipoide, proteinose alveolar e BOOP em alguns casos. E 68 casos evoluíram a óbito. CONCLUSÃO:O uso do cigarro eletrônico é uma nova forma de tabagismo

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A Case Series of Vaping-Induced Lung Injury in a Community Hospital Setting

Cited by 14 publications

References 8 publications

Pneumothorax secondary to vaping

Pneumothorax secondary to vaping

Characterizing e‐cigarette vaping‐associated lung injury in the pediatric intensive care unit

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

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