Extracorporeal Life Support for Respiratory Failure in Patients With Electronic Cigarette or Vaping Product Use-Associated Lung Injury.

Autor:	Gupta VS; Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX., Hayes D Jr; Department of Pediatrics, Division of Pulmonary Medicine and the Lung Transplant Program Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH., Hsu SC; Department of Pediatrics-Critical Care, UT Southwestern Medical Center, Dallas, TX., Tonna JE; Division of Cardiothoracic Surgery, Department of Surgery, Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT., Rycus PT; Extracorporeal Life Support Organization, Ann Arbor, MI., Bridges BC; Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN., Diaban F; Department of Critical Care Medicine, Mercy Hospital, St Louis, MO., Bosma KJ; Department of Medicine, Division of Critical Care Medicine, Schulich School of Medicine & Dentistry, Western University, and London Health Sciences Centre, London, ON, Canada., Bhatt JM; Department of Paediatric Respiratory Medicine, Nottingham University Hospitals, Nottingham, United Kingdom., Sakla NM; Department of Radiology, Newark Beth Israel Medical Center, Newark, NJ., Han JJ; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA., Bermudez CA; Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA., Manetta F; Department of Cardiovascular and Thoracic Surgery, Barbara and Donald Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY., Garcia EI; Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX., Harting MT; Department of Pediatric Surgery, McGovern Medical School at the University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX.
Jazyk:	angličtina
Zdroj:	Critical care medicine [Crit Care Med] 2022 Feb 01; Vol. 50 (2), pp. e173-e182.
DOI:	10.1097/CCM.0000000000005299
Abstrakt:	Objectives: Electronic cigarette or vaping product use-associated lung injury is a clinical entity that can lead to respiratory failure and death. Despite the severity of electronic cigarette or vaping product use-associated lung injury, the role of extracorporeal life support in its management remains unclear. Our objective was to describe the clinical characteristics and outcomes of patients with electronic cigarette or vaping product use-associated lung injury who received extracorporeal life support. Design: We performed a retrospective review of records of electronic cigarette or vaping product use-associated lung injury patients who received extracorporeal life support. Standardized data were collected via direct contact with extracorporeal life support centers. Data regarding presentation, ventilatory management, extracorporeal life support details, and outcome were analyzed. Setting: This was a multi-institutional, international case series with patients from 10 different institutions in three different countries. Patients: Patients who met criteria for confirmed electronic cigarette or vaping product use-associated lung injury (based on previously reported diagnostic criteria) and were placed on extracorporeal life support were included. Patients were identified via literature review and by direct contact with extracorporeal life support centers. Measurements and Main Results: Data were collected for 14 patients ranging from 16 to 45 years old. All had confirmed vape use within 3 months of presentation. Nicotine was the most commonly used vaping product. All patients had respiratory symptoms and radiographic evidence of bilateral pulmonary opacities. IV antibiotics and corticosteroids were universally initiated. Patients were intubated for 1.9 days (range, 0-6) prior to extracorporeal life support initiation. Poor oxygenation and ventilation were the most common indications for extracorporeal life support. Five patients showed evidence of ventricular dysfunction on echocardiography. Thirteen patients (93%) were placed on venovenous extracorporeal life support, and one patient required multiple rounds of extracorporeal life support. Total extracorporeal life support duration ranged from 2 to 37 days. Thirteen patients survived to hospital discharge; one patient died of septic shock. Conclusions: Electronic cigarette or vaping product use-associated lung injury can cause refractory respiratory failure and hypoxemia. These data suggest that venovenous extracorporeal life support can be an effective treatment option for profound, refractory respiratory failure secondary to electronic cigarette or vaping product use-associated lung injury. Competing Interests: Dr. Tonna is supported by a Career Development Award from the National Institutes of Health/National Heart, Lung, And Blood Institute (K23 HL141596). He received speaker fees and travel compensation from LivaNova and Philips Healthcare, unrelated to this work. Dr. Tonna’s institution received funding from LivaNova, Phillips Healthcare, and the National Heart, Lung, and Blood Institute; he received support for article research from the National Institutes of Health; he disclosed the off-label product use of extracorporeal membrane oxygenation. Dr. Bermudez received funding from Abbott acute mechanical circulatory support advisory board and Breethe/Abiomed. The remaining authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.)
Databáze:	MEDLINE
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