TY - JOUR
T1 - E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI) with Acute Respiratory Failure in Three Adolescent Patients
T2 - a Clinical Timeline, Treatment, and Product Analysis
AU - Billa, Ramya
AU - Tigges, Cody
AU - Vijayakumar, Niranjan
AU - Radke, Joshua
AU - Pedati, Caitlin
AU - Weiner, Rebecca
AU - McCabe, Daniel
N1 - Publisher Copyright:
© 2020, American College of Medical Toxicology.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Introduction: E-cigarette, or vaping, product use associated lung injury (EVALI) has become a recent concern among public health officials. Factors that contribute to the concern include an increasing number of cases over time, the severity of the illness, and an unknown understanding of the pathophysiology and etiology of the illness. Case Series: We cared for three adolescent patients with acute respiratory failure secondary to EVALI. All three patients were treated with high-dose steroids in addition to antimicrobials, which resulted in clinical improvement and resolution of their respiratory failure. Pulmonary function testing was performed on these previously healthy patients both acutely and subacutely. Additionally, we report the results from the laboratory analysis of one vaping device fluid which revealed previously unpublished components within these products. Discussion: EVALI is a recent public health concern without a known etiology which can cause life-threatening lung injury in patients without prior lung pathology. We hope these cases will highlight the importance of return precautions in adolescents with vague respiratory symptoms and provide a cautionary tale to providers while they counsel patients regarding the use of these products.
AB - Introduction: E-cigarette, or vaping, product use associated lung injury (EVALI) has become a recent concern among public health officials. Factors that contribute to the concern include an increasing number of cases over time, the severity of the illness, and an unknown understanding of the pathophysiology and etiology of the illness. Case Series: We cared for three adolescent patients with acute respiratory failure secondary to EVALI. All three patients were treated with high-dose steroids in addition to antimicrobials, which resulted in clinical improvement and resolution of their respiratory failure. Pulmonary function testing was performed on these previously healthy patients both acutely and subacutely. Additionally, we report the results from the laboratory analysis of one vaping device fluid which revealed previously unpublished components within these products. Discussion: EVALI is a recent public health concern without a known etiology which can cause life-threatening lung injury in patients without prior lung pathology. We hope these cases will highlight the importance of return precautions in adolescents with vague respiratory symptoms and provide a cautionary tale to providers while they counsel patients regarding the use of these products.
KW - ARDS
KW - EVALI
KW - Lung injury
KW - Vaping
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U2 - 10.1007/s13181-020-00765-9
DO - 10.1007/s13181-020-00765-9
M3 - Article
C2 - 32193828
AN - SCOPUS:85082825248
SN - 1556-9039
VL - 16
SP - 248
EP - 254
JO - Journal of Medical Toxicology
JF - Journal of Medical Toxicology
IS - 3
ER -