P0387 / #787: VAPING ASSOCIATED LUNG DISEASE: A CASE PRESENTATION

Abstract

Aims & Objectives: Vaping is an increasing alternative to smoking and widely considered a safe alternative. This case provides an example of a paediatric patient admitted to intensive care with an acute respiratory illness that presented a number of days after vaping. Methods: KB, a 14 year old, presented with abdominal pain and malaise. Her symptoms evolved to include dizziness, headache and nausea. Over 24 hours she developed worsening respiratory distress and hypoxia despite maximal high flow oxygen therapy.CXR showed ARDS. Consideration was given to starting steroids but they were not started. Following the arrival of the transport team, KB was intubated due to work of breathing, high oxygen requirement and tachycardia. Her pressure and oxygen requirement remained high and nitic was started. She was established on ventilator settings of 30/12 rate 23, nitric 20ppm and 50 percent oxygen. Despite high ventilator pressures CO2 remained high and she was started on HFOV. A large pleural effusion was drained. She was ventilated for a total of 4 days. She recovered well and was discharged. Initial lung function showed a restrictive defect which resolved. Results: CT chest. Widespread bilateral consolidation, pleural effusions. Deranged liver function and coagulopathy- PT 22.9 APTT 29 and fibrinogen 4.5. Gamma GT 300 CRP 300. Cultures and virology negative Conclusions: CDC case definition of confirmed case of vaping associated lung disease Vaping (within 90 days) AND pulmonary infiltrates AND absence of infection AND no plausible alternative diagnosis. KB would fit CDC criteria 2019 Vaping associated lung disease can cause respiratory failure in children.