Short-Term Outcomes From Pulmonary Rehabilitation In An Adolescent Patient With EVALI

Abstract

Widespread usage of electronic cigarettes (e-cigarettes) has driven the recent epidemic of e-cigarette, or vaping, product use associated lung injury (EVALI). Recent reports have described a heterogeneous range of pneumonitis-related sequelae from nonregulated tetrahydrocannabinol (THC) oil extract products used through various e-cigarette devices, piloting an ongoing federal investigation into the chemical constituents involved in such cases. However, to the best of our knowledge, no published reports to date have examined the impact of EVALI on post-discharge pulmonary function tests (PFTs), and the role of pulmonary rehabilitation in improving short-term functional outcomes. We describe the clinical course of an adolescent male with EVALI due to the use of an off-label THC based vaping pod. After a prolonged intubation period in the intensive care unit he exhibited exertional dyspnea at the outset of his rehabilitation. His initial PFTs were notable for a mixed obstructive and restrictive lung pattern and mildly decreased diffusion capacity. The patient had a slow and gradual improvement in his PFTs during pulmonary rehabilitation, as well as a stepwise improvement in his activities of daily living and resolution of substance abuse related stressors with continued supportive counseling.