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Vaping-Associated Lung Disease

Aka: Vaping-Associated Lung Disease
  1. See Also
    1. Electronic Cigarette (E-Cigarette, Vaping)
    2. Acute Nicotine Poisoning
  2. Epidemiology
    1. CDC is reporting 805 Vaping-related severe lung injury cases (and 10 deaths) as of 9/25/2019
  3. Mechanisms
    1. Acute Interstitial Lung Disease
      1. Related to diacetyl, flavorings, and solvents
    2. Lipoid Pneumonia (from oil aspiration) with alveolar Macrophage infiltration
      1. Vitamin E and diacetyl-induced popcorn lung have also been seen with Vaping
  4. Symptoms
    1. Fever and chills
    2. Fatigue
    3. Non-productive cough
    4. Dyspnea
    5. Chest Pain
    6. Nausea
    7. Vomiting
    8. Abdominal Pain
  5. Signs
    1. Pulse Oximetry
      1. Hypoxia
  6. Labs
    1. Complete Blood Count
      1. Leukocytosis
  7. Imaging
    1. Chest XRay
      1. Infiltrates may be present
    2. CT Chest
      1. Ground glass opacities may be present
  8. Management
    1. Hypoxia
      1. Supplemental Oxygen
      2. Noninvasive Positive Pressure Ventilation (e.g.BIPAP)
      3. Endotracheal Intubation
    2. Adjunctive
      1. High dose IV Corticosteroids
    3. Refractory, Critical Illness (e.g. cardiopulmonary collapse)
      1. ECMO
  9. Resources
    1. CDC
      1. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
  10. References
    1. Tomaszekski (2019) Crit Dec Emerg Med 33(10): 23

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