Vaping-associated pulmonary injury

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Vaping-associated pulmonary injury
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Cough, shortness of breath, chest pain, nausea, vomiting, diarrhea, fever, fatigue
Complications	Respiratory failure, pneumothorax, acute respiratory distress syndrome
Onset	Rapid, within days to weeks of vaping
Duration	Variable, can be prolonged
Types	N/A
Causes	Vaping
Risks	Use of e-cigarettes, especially those containing THC or vitamin E acetate
Diagnosis	Based on history of vaping, clinical presentation, and radiological findings
Differential diagnosis	Pneumonia, acute respiratory distress syndrome, hypersensitivity pneumonitis, chemical pneumonitis
Prevention	Avoidance of vaping products, especially those containing THC or vitamin E acetate
Treatment	Corticosteroids, supportive care, oxygen therapy, mechanical ventilation if needed
Medication	N/A
Prognosis	Variable, can be severe or fatal
Frequency	Outbreak in 2019, with over 2,800 cases reported in the United States
Deaths	N/A

Lung injury associated with vaping

Vaping-associated pulmonary injury (VAPI), also known as e-cigarette or vaping product use-associated lung injury (EVALI), is a serious medical condition characterized by lung damage resulting from the use of electronic cigarettes or other vaping devices. This condition emerged as a public health concern in the late 2010s, with numerous cases reported across the United States and other countries.

Symptoms

Individuals with VAPI typically present with a range of respiratory and systemic symptoms. Common respiratory symptoms include:

• Cough
• Shortness of breath
• Chest pain

Systemic symptoms may include:

• Fever
• Fatigue
• Nausea
• Vomiting
• Diarrhea

These symptoms can vary in severity and may lead to hospitalization in severe cases.

Causes

The exact cause of VAPI is not fully understood, but it is believed to be related to the inhalation of harmful substances present in vaping products. Potential culprits include:

• Vitamin E acetate, a thickening agent found in some THC-containing products
• Various flavoring agents
• Other chemical additives

The role of these substances in causing lung injury is an area of ongoing research.

Diagnosis

Microscopy of a bronchoalveolar lavage sample from a patient with VAPI.

Diagnosing VAPI involves a combination of clinical evaluation, imaging studies, and laboratory tests. Key diagnostic steps include:

• Detailed patient history, focusing on recent use of vaping products
• Chest X-ray or CT scan to assess lung damage
• Bronchoscopy with bronchoalveolar lavage to obtain samples for analysis

Treatment

Treatment of VAPI primarily involves supportive care, which may include:

• Oxygen therapy
• Mechanical ventilation in severe cases
• Corticosteroids to reduce inflammation

Patients are advised to discontinue the use of vaping products immediately.

Prevention

Preventing VAPI involves avoiding the use of vaping products, particularly those containing THC or other unregulated substances. Public health campaigns aim to raise awareness about the risks associated with vaping.

Epidemiology

The outbreak of VAPI cases in 2019 highlighted the widespread use of vaping products among young adults and adolescents. The condition has been reported predominantly in the United States, with cases also emerging in other countries.

See also

• Electronic cigarette
• Lung disease
• Public health

External links

• CDC Information on Vaping-Associated Lung Injury