Vaping Associated Pulmonary Injury

Aparna Alavalapadu,Raphael Mattamal

doi:10.36013/ijipem.v7i.75

Abstract

Vaping-associated pulmonary injury (VAPI) is a newly evolving medical condition caused by inhalation of substances including tetrahydrocannabinol- or nicotine-containing products via vaping. Vaping is the act of inhaling and exhaling an aerosol, which can contain fine particles that have been identified as toxic chemicals, produced by an e-cigarette or similar device. Presenting symptoms of VAPI include respiratory symptoms (dyspnea, chest pain, cough, and hypoxia), gastrointestinal symptoms (nausea, emesis, diarrhea, and abdominal pain), and constitutional symptoms (fever, chills, weight loss, and fatigue). The diagnosis and management of VAPI are being studied and it is considered a diagnosis of exclusion. Most patients are young, with male predominance, and history of vaping. The severity of presenting symptoms varies. Radiographic findings vary in severity with chest x-rays showing bilateral infiltrates, although those findings may be absent early in the disease course. Computed tomography of the chest can show bilateral ground-glass opacities with pleural effusions and pneumomediastinum. Management of VAPI is based upon clinical presentation with empiric antibiotics for CAP coverage and steroids if indicated for reducing lung inflammation.

Highlights

Vaping-associated pulmonary injury (VAPI) is a newly evolving medical condition caused by inhalation of substances including tetrahydrocannabinol (THC) or nicotine
Vaping is the act of inhaling and exhaling an aerosol containing fine particles that may be identified as toxic chemicals, produced by an e-cigarette or similar device
Healthy young adults with no significant medical histories are simpler to diagnose with VAPI given a positive vaping history, lack of other reported exposures, and lack of response to standard therapies for community acquired pneumonia

Summary

INTRODUCTION

Vaping-associated pulmonary injury (VAPI) is a newly evolving medical condition caused by inhalation of substances including tetrahydrocannabinol (THC) or nicotine. CASE REPORTS Patient 1 was a 16-year-old male with severe GI symptoms (roughly 10 episodes per day of nonbilious nonbloody emesis with maximum 9/10 abdominal pain for over a week) , respiratory symptoms (nonproductive cough and pleuritic chest pain), and fever of 102.6° F for 6 days prior to presentation. Patient 2 was an 18-year-old female with fever greater than 101° F, weight loss of 9 pounds, and respiratory symptoms (cough, shortness of breath, hypoxemia, squeezing substernal chest pain, and severe deconditioning indicated by inability to climb stairs) for 5 days prior to presentation. She had been vaping THC for 3 months.

DISCUSSION

CONCLUSION