Clinical Features of E-cigarette, or Vaping, Product Use–Associated Lung Injury in Teenagers
| Autor: | Vineeta Mittal, Maddy Artunduaga, Jenny K.R. Francis, Kim Aldy, Dazhe James Cao, Devika R. Rao, Tiffany J. Lieu, Kendra L. Maple, Sing Yi Feng, Amy Dettori, Stephanie Hsu, Folashade Afolabi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Vital capacity Adolescent MEDLINE Electronic Nicotine Delivery Systems Lung injury Tertiary care Article Pulmonary function testing law.invention 03 medical and health sciences 0302 clinical medicine law Commentaries 030225 pediatrics medicine Humans Retrospective Studies business.industry Vaping Smoking Retrospective cohort study Tobacco Products Lung Injury United States Pediatrics Perinatology and Child Health Female Ground glass business Electronic cigarette |
| Zdroj: | Pediatrics |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2019-4104 |
| Popis: | BACKGROUND: In the United States in 2019, there was an outbreak of electronic cigarette, or vaping, product use–associated lung injury (EVALI). The manifestations of EVALI in adolescents are not well characterized. We describe the diagnosis, evaluation, and management of EVALI in adolescents hospitalized at a tertiary care, university-affiliated children’s hospital. METHODS: A multidisciplinary committee developed an EVALI algorithm on the basis of guidelines from the Centers for Disease Control and Prevention. A retrospective chart review was conducted on patients diagnosed with EVALI. Descriptive analyses included sociodemographic characteristics, clinical presentation, laboratory and imaging results, pulmonary function testing, oxygen requirements, and clinic follow-up. RESULTS: Thirteen hospitalized adolescents were diagnosed with confirmed or probable EVALI. The majority were female (54%) with a mean age of 15.9 years. Sixty-nine percent of patients presented with respiratory symptoms, whereas gastrointestinal symptoms were prominent in 85% of patients. Vaping Δ-9-tetrahydrocannabinol was reported in 92% of patients, and vaping nicotine was reported in 62% of patients. All had bilateral ground-glass opacities on the chest computed tomography (CT) scan. Treatment with glucocorticoids led to clinical improvement in 11 of 12 patients. Treatment with glucocorticoids led to improvement in both forced expiratory volume in 1 second and forced vital capacity (P < .05). Four patients required home oxygen on the basis of 6-minute walk test results. CONCLUSIONS: Diagnosis of EVALI should be suspected on the basis of vaping history and clinical presentation. Glucocorticoid treatment led to an improvement in symptoms and lung function. The 6-minute walk test may help determine oxygen needs at discharge. |
| Databáze: | OpenAIRE |
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