Pulmonary and critical care considerations for e-cigarette, or vaping, product use-associated lung injury.

Details

• Personal Author:
  Board A ; Calfee CS ; Callahan SJ ; Click ES ; Crotty Alexander LE ; Eakin MN ; Ellington S ; Esper AM ; Evans ME ; Ewart G ; Goodman AB ; Hayes D Jr. ; Kathuria H ; Meyer NJ ; Novosad S ; Pollack LA ; Robinson RT ; Sharma NS ; Smith LS ; Twentyman E ; Weissman, David N.
• Description:
  Background: In 2019, the United States experienced a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). More than half of these patients required admission to an intensive care unit (ICU). Methods: To synthesize information critical to pulmonary/critical care specialists in the care of patients with EVALI, we examined data available from patients hospitalized with EVALI between August 2019 and January 2020; reviewed the clinical course and critical care experience with those patients admitted to the ICU; and compiled opinion of national experts. Results: Of the 2,708 confirmed or probable EVALI patients requiring hospitalization as of January 21, 2020, 1,604 (59.2%) had data available on ICU admission; of these, 705 (44.0%) were admitted to the ICU and are included in this analysis. The majority of ICU patients required respiratory support (88.5%), and in severe cases required intubation (36.1%), or extracorporeal membrane oxygenation (ECMO) (6.7%). The majority (93.0%) of these ICU patients survived to discharge. Review of the clinical course and expert opinion provided insight into: imaging; considerations for bronchoscopy; medical treatment, including use of empiric antibiotics, antivirals, and corticosteroids; respiratory support, including considerations for intubation, positioning maneuvers, and ECMO; and patient outcomes. Conclusions: Review of the clinical course of EVALI patients requiring ICU admission and compilation of expert opinion provided critical insight into pulmonary/critical care-specific considerations for this patient population. As a large proportion of patients hospitalized with EVALI required ICU admission, it is important to remain prepared to care for patients with EVALI. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Electrical Equipment And Supplies Lung Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Author Keywords: Critical Illness; E-cigarette; ICU: Lung Injury; Vaping Lung Irritants; Respiratory Diseases; Pulmonary Disorders; Medical Care; Medical Treatment; Health Care; Medical Records; Clinical Symptoms; Electronic Devices;
• ISSN:
  0012-3692
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Georgia ; Maryland ; Massachusetts ; New York ; Ohio ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 5 ; OSHA Region 8 ; OSHA Region 9 ; Pennsylvania ; Utah ; Washington ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  256-264
• Volume:
  162
• Issue:
  1
• NIOSHTIC Number:
  nn:20064813
• Citation:
  Chest 2022 Jul; 162(1):256-264
• Contact Point Address:
  Don Hayes, Jr., MD, FCCP, Professor and Medical Director, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 7041, Cincinnati, OH 45229
• Email:
  Don.Hayes@cchmc.org
• Federal Fiscal Year:
  2022
• Peer Reviewed:
  True
• Source Full Name:
  Chest
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a0b103ada1ec494f64f28230b47650b02df183743a0541893ab32f3ef18bcdfaea4d0bc31815124638e0ec4b5c0a7bb6aeba45c233027ee9ad5fa7a6f1b8dbf6
• Download URL:
  https://stacks.cdc.gov/view/cdc/249245/cdc_249245_DS1.pdf
• File Type:
  [PDF - 253.95 KB ]