Pneumorachis and pneumomediastinum caused by repeated Müller's maneuvers: Complications of marijuana smoking

Hazouard, E.; Koninck, Jean-Christophe; Attucci, Sylvie; Fauchier-Rolland, Florence; Brunereau, L.; Diot, Patrice

doi:10.1067/mem.2001.118016

Cited by 91 publications

(66 citation statements)

References 14 publications

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“…A number of cases of spontaneous pneumothorax and/or pneumomediatinum associated with marijuana smoking have been reported [60][61][62][63][64][65][66][67]. The mechanism of this association is believed to be due to the repeated performance of prolonged Valsalva maneuvers during breathholding following deep inhalation of the smoke.…”

Section: Pulmonary Barotrauma and Bullous Lung Diseasementioning

confidence: 99%

“…These maneuvers could lead to barotrauma with rupture of subpleural blebs or alveoli and dissection of air around the vessels and bronchi to the pleural space or mediastinum. Alternatively, successive deep inhalations through a smoking apparatus with a high airflow resistance equivalent to Muller's maneuver could have a similar effect [64,67] as a result of extreme negative intrathoracic pressure and high transmural pressure gradients inducing barotrauma.…”

Section: Pulmonary Barotrauma and Bullous Lung Diseasementioning

confidence: 99%

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Smoked Marijuana as a Cause of Lung Injury

Tashkin

2005

Monaldi Arch Chest Dis

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P. Tashkin. In many societies, marijuana is the second most commonly smoked substance after tobacco. While Δ9-tetrahydrocannabinol (THC) is unique to marijuana and nicotine to tobacco, the smoke of marijuana, like that of tobacco, consists of a toxic mixture of gases and particulates, many of which are known to be harmful to the lung. Although far fewer marijuana than tobacco cigarettes are generally smoked on a daily basis, the pulmonary consequences of marijuana smoking may be magnified by the greater deposition of smoke particulates in the lung due to the differing manner in which marijuana is smoked. Whereas THC causes modest short-term bronchodilation, regular marijuana smoking produces a number of long-term pulmonary consequences, including chronic cough and sputum, histopathologic evidence of widespread airway inflammation and injury and immunohistochemical evidence of dysregulated growth of respiratory epithelial cells, that may be precursors to lung cancer. The THC in marijuana could contribute to some of these injurious changes through its ability to augment oxidative stress, cause mitochondrial dysfunction, and inhibit apoptosis. On the other hand, physiologic, clinical or epidemiologic evidence that marijuana smoking may lead to chronic obstructive pulmonary disease or respiratory cancer is limited and inconsistent. Habitual use of marijuana is also associated with abnormalities in the structure and function of alveolar macrophages, including impairment in microbial phagocytosis and killing that is associated with defective production of immunostimulatory cytokines and nitric oxide, thereby potentially predisposing to pulmonary infection. In view of the growing interest in medicinal marijuana, further epidemiologic studies are needed to clarify the true risks of regular marijuana smoking on respiratory health.

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Section: Pulmonary Barotrauma and Bullous Lung Diseasementioning

confidence: 99%

Section: Pulmonary Barotrauma and Bullous Lung Diseasementioning

confidence: 99%

Smoked Marijuana as a Cause of Lung Injury

Tashkin

2005

Monaldi Arch Chest Dis

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“…However, observational surveys of heavy, chronic cannabis use have failed to find any lung damage in long-term smokers (21). Pneumomediastinum and pneumothorax have been reported following the prolonged Valsalva manoeuvre that may accompany cannabis smoking (possibly through rupturing emphysematous bullae) (22)(23)(24)(25).…”

Section: Quality Concernsmentioning

confidence: 99%

Safety Issues Concerning the Medical Use of Cannabis and Cannabinoids

Ware

Tawfik

2005

Pain Research and Management

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Safety issues are a major barrier to the use of cannabis and cannabinoid medications for clinical purposes. Information on the safety of herbal cannabis may be derived from studies of recreational cannabis use, but cannabis exposure and effects may differ widely between medical and recreational cannabis users. Standardized, quality-controlled cannabinoid products are available in Canada, and safety profiles of approved medications are available through the Canadian formulary. In the present article, the evidence behind major safety issues related to cannabis use is summarized, with the aim of promoting informed dialogue between physicians and patients in whom cannabinoid therapy is being considered. Caution is advised in interpreting these data, because clinical experience with cannabinoid use is in the early stages. There is a need for long-term safety monitoring of patients using cannabinoids for a wide variety of conditions, to further guide therapeutic decisions and public policy.

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“…Marijuana smokers often embrace the hazardous practice of "shotgunning", a practice of inhaling smoke and then exhaling it with positive pressure into another person's mouth. Other practices like engaging in the Muller or Valsalva maneuver while smoking marijuana may also result in pulmonary barotraumas [5,6].…”

Section: Discussionmentioning

confidence: 99%

Marijuana Use and the Development of Status Asthmaticus: A Case Report

Alexis¹,

Bhangle²,

Fless³

2012

OJAnes

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Introduction: Status asthmaticus is an acute exacerbation of asthma caused by increased airflow resistance and mucus plugging. Symptoms of dyspnea may lead to respiratory failure and cardiac arrest. There is limited knowledge about the effects of marijuana on pulmonary function. We report a unique case of status asthmaticus related to frequent marijuana use. Case Presentation: A 38-year-old African American male with a past medical history of asthma and two prior episodes of status asthmaticus arrived at Saint Barnabas Medical Center with dyspnea and wheezing that was refractory to home albuterol nebulizer therapy. Despite medical treatment his symptoms did not improve and he collapsed to the floor and required intubation and mechanical ventilation. He reported having smoked marijuana numerous times on the day prior to this admission. He was discharged three days later and was strongly advised to stop smoking marijuana. Conclusion: Marijuana is a commonly smoked illicit drug. Although habitual marijuana smokers have symptoms of cough, phlegm and wheezing, we found no reports linking marijuana use to the development of status asthmaticus. Given the rampant abuse of marijuana and its likely burden on healthcare, physicians should be vigilant in discussing the harmful effects of marijuana with asthmatic patients who abuse this drug.

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Pneumorachis and pneumomediastinum caused by repeated Müller's maneuvers: Complications of marijuana smoking

Cited by 91 publications

References 14 publications

Smoked Marijuana as a Cause of Lung Injury

Smoked Marijuana as a Cause of Lung Injury

Safety Issues Concerning the Medical Use of Cannabis and Cannabinoids

Marijuana Use and the Development of Status Asthmaticus: A Case Report

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