THC Vaping-Induced Acute Respiratory Distress Syndrome

Qarajeh, Raed; Kitchen, Jacqueline F

doi:10.1016/j.amjmed.2019.09.015

Cited by 8 publications

(8 citation statements)

References 2 publications

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“…Tables 2 and 3. Most common diagnosis was EVALI (n = 15) [26][27][28][29][30][31][32][33][34][35][36] or EVALI with an additional finding (n = 1) [37]. Second most common diagnosis included either organizing pneumonia/ Bronchiolitis obliterans with organizing pneumonia (BOOP)/ respiratory bronchiolitis (n = 12) [38][39][40][41][42][43][44][45][46] or lipoid pneumonia (n = 9) [11,[47][48][49][50][51].…”

Section: Classification Of Casesmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

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Section: Classification Of Casesmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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“…Influenza is one of the consistent causes of death attributed to viral pneumonias every year [14]. EVALI due to vaping has been recently recognized as a concern in young patients who use vaping 168 devices [1][2][3][4][5][6][7][8]. Our patient had a complex of influenza-related severe lung injury and rhabdomyolysis further complicated by vaping of a mixture of Vitamin-E and THC.…”

Section: Discussionmentioning

confidence: 98%

“…The use of vaping devices is especially prevalent in the age group of 11 to 34-year-olds [1]. While the mechanism of lung injury in patients who vape is under investigation at the state and federal levels, vitamin E acetate, a chemical used to dilute tetrahydrocannabinol (THC) oil in vape cartridges, has emerged as one of the likely causes of EVALI [3][4][5][6][7]. In January 2020, the FDA finalized a policy that will prioritize enforcement against certain e-cigarette flavors and manufacturers of products that are targeted to minors or have failed to take adequate measures to prevent minors' access [8].…”

Section: Introductionmentioning

confidence: 99%

“…In January 2020, the FDA finalized a policy that will prioritize enforcement against certain e-cigarette flavors and manufacturers of products that are targeted to minors or have failed to take adequate measures to prevent minors' access [8]. The aim is to significantly reduce the prevalence of vaping among children while still providing a viable alternative for current combustible tobacco smokers, seeking to cut back [4]. We present a fatal case of EVALI complicated by Influenza-related Acute Respiratory Distress Syndrome (ARDS) ( Table 1).…”

Section: Introductionmentioning

confidence: 99%

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Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Akkanti¹,

Hussain²,

Patel³

et al. 2020

Diagn Pathol

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Background: E-cigarette and vaping use-associated acute lung injury (EVALI) has been recently recognized as a complication in individuals who use vaping devices. Another consideration is that EVALI may have an adverse influence on the outcome of intercurrent respiratory infections. We document this deadly combination in the case of a young man who had EVALI and simultaneous Influenza-A infection leading to severe Acute Respiratory Distress Syndrome (ARDS). Case presentation: A 27-year-old male with a history of tobacco and vaping use was admitted to hospital after two weeks of flu-like symptoms, diarrhea and vomiting. A chest x-ray was consistent with multifocal pneumonia, and microbiological tests were positive for Influenza-A and methicillin-sensitive Staphalacoccus aureus (MSSA). Bronchoscopy provided evidence of acute inhalational injury. After admission, he acutely decompensated with severe hypoxia and hypotension; he required intubation, sedation and vasopressors. He developed sepsis with acute kidney failure, liver failure, biventricular systolic dysfunction and severe rhabdomyolysis. He was placed on veno-venous (VV) extracorporeal membrane oxygenation (ECMO) initially and later changed to Veno-Arterial (VA) ECMO. Nevertheless, the patient continued to deteriorate, and he expired two weeks after admission. Conclusion: This case documents that EVALI can act as a major factor leading a respiratory infection to progress into severe ARDS with a fatal outcome.

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“…and Kitchen (2019) 51 47/M Authors present a patient with past medical conditions (diabetes and hypertension) , vaping (with THC) and traditional cigarette use and presented to ED. Chest X-ray and CT showed opacities and pleural effusions.…”

Section: Qarajehmentioning

confidence: 99%

Chemistry Review of Vaping Products and Respiratory Injury

2020

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Background: While the Public Health Agency of Canada notes 19 cases from May 2019 to February 2020 relating to e-cigarette or vaping product use-associated lung injury (EVALI) in Canada, there are likely many more unreported cases, including non-hospitalized and asymptomatic cases. E-cigarette use or vaping exposes users to numerous aerosolized chemical species, some of which have proven to be deleterious to health. These chemical species can include vitamin E acetate (VEA), flavourants, base / solvents (propylene glycol or vegetable glycerin), psychoactive substances, pesticides, endotoxins, metals, and pyrolysis by-products from e-cigarette heating coils. Objectives: We aim to review current findings related to EVALI from the standpoint of known chemical species currently used in vaping products. We specifically examine the toxicological profiles of these chemical species and the mechanisms through which they cause lung injury. Methods: A comprehensive literature search was performed with MEDLINE for EVALI-related human studies that were published between January 1, 2010, and May 15, 2020. This search strategy identified 832 case reports, case series, clinical trials, and in-vitro laboratory studies. From this group, 71 records were examined in greater detail. Results and Conclusions: Although the chemical composition and toxicology of vaping products have largely been characterized, the physiological effects of the chemical interactions between various constituents of vaping products and the generation of new species remain inconclusive. Given the rapid increase in the popularity of vaping and e-cigarettes, there is a need for further research. Developing a comprehensive understanding of the chronic health effects of vaping through randomized controlled trials and physiological studies is prudent and necessary to reduce the long-term impacts on users and the health care system.

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THC Vaping-Induced Acute Respiratory Distress Syndrome

Cited by 8 publications

References 2 publications

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Chemistry Review of Vaping Products and Respiratory Injury

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