Journal article
E-cigarette or vaping product use–associated lung injury: A review of clinico-radio-pathological characteristics
Respiratory investigation, Vol.60(6), pp.738-749
11/2022
DOI: 10.1016/j.resinv.2022.06.011
Abstract
Aggressive, albeit false marketing of electronic nicotine delivery systems (ENDS) or vaping devices as safer alternatives to cigarette smoking, combined with lack of regulations, has led to its mass adoption, especially among youth. A sudden increase in acute lung injuries was noted in 2019 which was linked to ENDS. It was termed by the Centers for Disease Control and Prevention (CDC) as electronic cigarette or vaping product use-associated lung injury (EVALI). Analysis of bronchoalveolar lavage fluid samples linked EVALI to vitamin E acetate (VEA), which is used as a diluting agent for marijuana oils. Patients with EVALI present with a combination of non-specific respiratory, gastrointestinal, and systemic symptoms. Laboratory results may show elevated inflammatory biomarkers. EVALI is a diagnosis of exclusion and must meet the following criteria: i) history of vaping within last 90 days, ii) abnormal chest imaging, iii) negative evaluation for infection, and iv) no other plausible diagnosis. A spectrum of computed tomography (CT) chest findings has been reported in EVALI, ranging from diffuse alveolar damage to organizing pneumonia, characterized by bilateral ground-glass opacities, consolidation, and septal thickening. A similar spectrum is seen on histopathology, characterized by lipid-laden alveolar macrophages, with varying degrees of infiltrative inflammatory cells and fibrin deposition. Early and accurate identification of the EVALI pattern can help optimize patient care. For example, in diffuse alveolar damage (DAD), a lower threshold for ventilation support and corticosteroid may improve outcomes. Here, we review the etiopathogenesis, clinical management, histopathology, and imaging features of EVALI.
Details
- Title: Subtitle
- E-cigarette or vaping product use–associated lung injury: A review of clinico-radio-pathological characteristics
- Creators
- Ishan Garg - Arkana LaboratoriesAditi Vidholia - University of Wisconsin–MadisonAnkita Garg - Dr. Ram Manohar Lohia HospitalShuchita Singh - Shanti Hospital, Rajeev Nagar, Agra, Uttar Pradesh 282005, India.Alireza Agahi - Mayo ClinicArchana Laroia - University of Iowa Hospitals and ClinicsSachin S. Saboo - Radiology AssociatesAlejandro P. Comellas - Roy J. and Lucille A. Carver College of MedicineEric A. Hoffman - University of IowaPrashant Nagpal - University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- Respiratory investigation, Vol.60(6), pp.738-749
- DOI
- 10.1016/j.resinv.2022.06.011
- ISSN
- 2212-5345
- eISSN
- 2212-5353
- Publisher
- Elsevier B.V
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01HL130883, U01HL089897, U01HL137880
- Language
- English
- Date published
- 11/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318795902771
Metrics
5 Record Views