Vaping-associated acute respiratory distress syndrome

Abstract

Vaping-associated lung injury via the use of electronic nicotine delivery systems (ENDS) is currently being evaluated as a potential source of pulmonary injury with uncertain etiology as the use of tetrahydrocannabinol (THC) is increasing throughout the USA. ENDS are marketed to be unlike traditional cigarette smoking in that they are purported to contain only propylene glycol, vegetable glycerine, nicotine, and flavorants compared with the > 60 carcinogenic ingredients in cigarettes. The New England Journal of Medicine (NEJM) currently reports four imaging patterns correlated with vaping-attributed pathology including acute eosinophilic pneumonia, diffuse alveolar damage, organizing pneumonia, and lipoid pneumonia. The incidence and extent of lung disease in otherwise young healthy patients with a history of vaping has not however been definitively recognized within the field of radiology. We present a case of vaping-associated acute respiratory distress syndrome (ARDS) in a young patient with no additional past medical history. The immediate radiologic recognition of vaping as a risk factor for ARDS in the emergency setting is pivotal so that appropriate medical management and respiratory support can be initiated without delay.

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

“…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].…”

Fundamentals of Vaping-Associated Pulmonary Injury Leading to Severe Respiratory Distress

“…Pathological outcomes of vaping vary dramatically in humans as well as laboratory models, but occurrence of severe VAPI in the clinical setting is a serious and growing concern in society. (10)(11)(12)(13)(14)(15)(16)(17) The VAPI model developed in this report provides an experimental platform for this understudied syndrome, exhibiting a collective set of distinguishing characteristics without precedent in the literature. Foremost, phenotypic manifestations are reminiscent of clinical case reports of individuals hospitalized for severe VAPI including tissue damage, inflammatory responses, and cardiopulmonary failure.…”

“…1-8) demonstrates severe damage to lung tissue. The clinical syndrome of severe VAPI has been associated with cardiac dysfunction (15,16,50) prompting assessment of myocardial structure and function in vaped mice following the 9…”

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

“…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…”