Lung Transplantation for the Treatment of Vaping-Induced, Irreversible, End-Stage Lung Injury

Nemeh, Hassan; Coba, Victor; Chulkov, Maria; Gupta, Arielle Hodari; Yeldo, Nicholas; Chamogeorgakis, Themistokles; Tanaka, Daizo; Allenspach, Lisa; Simanovski, Jane; Shanti, Christina

doi:10.1016/j.athoracsur.2020.07.097

Cited by 14 publications

(7 citation statements)

References 5 publications

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“…Although most patients improve with the above-mentioned treatments, some cases may continue to progress. There are reports of extracorporeal membrane oxygenation utilization as a bridge to recovery and very few cases of lung transplant for EVALI with end-stage lung disease [15]. Currently, there are few transplant centers that accept such patients.…”

Section: Discussionmentioning

confidence: 99%

A Case Series of E-cigarette or Vaping-Associated Lung Injury With a Review of Pathological and Radiological Findings

Pourshahid¹,

Khademolhosseini²,

Hussain³

et al. 2022

Cureus

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There has been a recent outbreak of e-cigarette or vaping-associated lung injury (EVALI) but the exact pathophysiology remains unknown. Tetrahydrocannabinol (THC) and vitamin E derivates are the major components in vaping-generated aerosols that are associated with EVALI. So far, there is no standard treatment for EVALI. Most cases are treated with antibiotics and steroids. Counseling for smoking cessation is an integral part of care for EVALI patients. Referral to addiction medicine may be beneficial. Considering the nonspecific presenting symptoms and the growing popularity of vaping devices, providers need to consider EVALI in the differential diagnosis of bilateral patchy ground-glass opacities with respiratory, constitutional, or gastrointestinal symptoms in patients using e-cigarettes. Here, we present four EVALI cases and review the pertinent imaging and pathological findings.

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Section: Discussionmentioning

confidence: 99%

A Case Series of E-cigarette or Vaping-Associated Lung Injury With a Review of Pathological and Radiological Findings

Pourshahid¹,

Khademolhosseini²,

Hussain³

et al. 2022

Cureus

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“…The authors concluded in this study that there is a need of an observation for the long-term implications of ecigarettes (66). Nemeh et al also reported a single case of EVALI in a 16-year-old patient using ecigarette, nicotine, and tetrahydrocannabinol for 6-8 months (67). A descriptive analysis of EVALI cases in Canada from September 2019 to December 2019 has concluded that factors influencing EVALI in Canada are complex and multifactorial, and the lack of evidence make it important to investigate the longterm health effects of nicotine and cannabis vaping, including the possible influence on susceptibility to infectious diseases (68).…”

Section: Long-term Health Effects Of E-cigarettesmentioning

confidence: 97%

A Review of Electronic Cigarettes and Liquid Nicotine Poisoning Exposure Cases in the United States

Ahmed

2022

J Pharm Pharm Sci

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Purpose: In 2007, electronic cigarettes (e-cigarette) were introduced as a smoking cessation device. Since then, its sale and marketing has been expanded annually. Concomitantly, there is an increase in the electronic cigarette (e-cigarette) and liquid nicotine exposure cases reported to the United States (US) poison control centers. The purpose of this review is to assess the exposure cases reported to US poison control centers to characterize the adverse health effects of e-cigarette and liquid nicotine use. Methods: The PubMed database was searched for e-cigarette and e-liquid exposure reports since 2010. The qualitative analysis was conducted to depict the characteristics related to the incident cases and health outcomes of e-cigarette and e-liquid exposure to support public awareness. Results: Since 2010, there was an increase in e-cigarette exposure incidents with ingestion, inhalation, ocular and dermal identified as the commonly reported routes of exposure in both children and adults. The clinical symptoms were well characterized based upon the specific route of exposure. The exposure incidents were categorized into age, sex, type of exposure, symptoms, management site and medical outcome. The children less than 5 years of age were unintentionally exposed followed by both unintentional and intentional exposure in adults. The reported medical outcomes have a range from minor effects exhibiting symptoms that were not bothersome to major effects with life-threatening symptoms, and death. The short-term or acute exposure was mostly associated with mishandling or misuse of the e-cigarette device or e-liquid. The case reports of young adult males who are linked to intensive use of e-cigarettes show lung injury. Conclusion: E-liquid and e-cigarette use continue to pose a serious health risk for both adults and children. There is accumulating data of incidents associated with short-term e-cigarette use or intensive use of e-cigarettes. However, monitoring of the long-term health effect of e-cigarettes is needed in order to raise public awareness among young adults.

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“…After recovery and with cessation, most follow-up studies found the majority of patients had resolution of imaging abnormalities ( 28 , 90 ). However, there are rare instances of persistent parenchymal changes and scarring ( 28 , 91 ).…”

Section: Evali Clinical Carementioning

confidence: 99%

The E-cigarette or Vaping Product Use–Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions: An Official American Thoracic Society Workshop Report

Rebuli¹,

Rose²,

Noël³

et al. 2023

Annals ATS

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E-cigarette or vaping product use–associated lung injury (EVALI) is a severe pulmonary illness associated with the use of e-cigarettes or vaping products that was officially identified and named in 2019. This American Thoracic Society workshop was convened in 2021 to identify and prioritize research and regulatory needs to adequately respond to the EVALI outbreak and to prevent similar instances of disease associated with e-cigarette or vaping product use. An interdisciplinary group of 26 experts in adult and pediatric clinical care, public health, regulatory oversight, and toxicology were convened for the workshop. Four major topics were examined: 1 ) the public health and regulatory response to EVALI; 2 ) EVALI clinical care; 3 ) mechanisms contributing to EVALI; and 4 ) needed actions to address the health effects of EVALI. Oral presentations and group discussion were the primary modes used to identify top priorities for addressing EVALI. Initiatives including a national EVALI case registry and biorepository, integrated electronic medical record coding system, U.S. Food and Drug Administration regulation and enforcement of nicotine e-cigarette standards, regulatory authority over nontobacco-derived e-cigarettes, training in evaluating exogenous exposures, prospective clinical studies, standardized clinical follow-up assessments, ability to more readily study effects of cannabinoid e-cigarettes, and research to identify biomarkers of exposure and disease were identified as critical needs. These initiatives will require substantial federal investment as well as changes to regulatory policy. Overall, the workshop identified the need to address the root causes of EVALI to prevent future outbreaks. An integrated approach from multiple perspectives is required, including public health; clinical, basic, and translational research; regulators; and users of e-cigarettes. Improving the public health response to reduce the risk of another substantial disease-inducing event depends on coordinated actions to better understand the inhalational toxicity of these products, informing the public of the risks, and developing and enforcing regulatory standards for all e-cigarettes.

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Lung Transplantation for the Treatment of Vaping-Induced, Irreversible, End-Stage Lung Injury

Cited by 14 publications

References 5 publications

A Case Series of E-cigarette or Vaping-Associated Lung Injury With a Review of Pathological and Radiological Findings

A Case Series of E-cigarette or Vaping-Associated Lung Injury With a Review of Pathological and Radiological Findings

A Review of Electronic Cigarettes and Liquid Nicotine Poisoning Exposure Cases in the United States

The E-cigarette or Vaping Product Use–Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions: An Official American Thoracic Society Workshop Report

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