Vaping-Associated Lung Disease

Aka: Vaping-Associated Lung Disease

II. Epidemiology

  1. CDC is reporting 805 Vaping-related severe lung injury cases (and 10 deaths) as of 9/25/2019

III. 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

IV. Symptoms

  1. Fever and chills
  2. Fatigue
  3. Non-productive cough
  4. Dyspnea
  5. Chest Pain
  6. Nausea
  7. Vomiting
  8. Abdominal Pain

V. Signs

  1. Pulse Oximetry
    1. Hypoxia

VI. Labs

  1. Complete Blood Count
    1. Leukocytosis

VII. Imaging

  1. Chest XRay
    1. Infiltrates may be present
  2. CT Chest
    1. Ground glass opacities may be present

VIII. 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

IX. Resources

  1. CDC
    1. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

X. References

  1. Tomaszekski (2019) Crit Dec Emerg Med 33(10): 23

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