A Case of Vaping TCH Oil Leading to Vaping Associated Pulmonary Injury: Our Approach to Its Diagnosis, Management, and Recommendations

Singh, Anshika; Tan, Qiuxue; Saccone, Nicole M.; Lindner, D.

doi:10.1155/2020/6138083

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…Tables 2 and 3. Most common diagnosis was EVALI (n = 15) [26][27][28][29][30][31][32][33][34][35][36] or EVALI with an additional finding (n = 1) [37]. Second most common diagnosis included either organizing pneumonia/ Bronchiolitis obliterans with organizing pneumonia (BOOP)/ respiratory bronchiolitis (n = 12) [38][39][40][41][42][43][44][45][46] or lipoid pneumonia (n = 9) [11,[47][48][49][50][51].…”

Section: Classification Of Casesmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

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Section: Classification Of Casesmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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“…There are no other case reports with a similar presentation to our clinical case. However, there are several case reports detailing CBD oil vaping causing acute lung injury and respiratory distress [7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal Bleeding Due to Cannabidiol Oil Vape Use

Pankhania¹,

Liu²,

Grounds³

2021

Cureus

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Vaping has become an increasingly popular alternative to smoking in recent years. We present a rare and unusual case of upper airway bleeding caused by inhalation of a cannabidiol (CBD) oil-based vape due to a chemical burn. There are no case reports of this injury in the literature, and we discuss the clinical presentation, diagnosis and our management of this potentially life-threatening injury.A 27-year-old man presented to the accident and emergency department after using a CBD oil vape. After one inhalation of the CBD oil vape, the patient experienced immediate onset pain in the oropharynx, dyspnoea, expectoration of blood and hoarseness. The patient had used a CBD oil vape four hours earlier that evening for the first time, which was procured from an unregulated online source.The patient was referred to the Ear, Nose and Throat (ENT) team where the examination of oropharynx identified a posterior pharyngeal bleeding point. Flexible nasal endoscopy was undertaken showing profound erythema and inflammation throughout the oropharynx and posterior pharyngeal wall. The mucous membranes had been detached leaving an exposed bleeding submucosa.The patient was commenced on three cycles of back-to-back adrenaline nebulisers (1:1000 adrenaline in 5ml of 0.9% NaCl), 6.6mg dexamethasone intravenously and hydrogen peroxide gargles (5ml of 3% hydrogen peroxide in 10ml of water) three times a day. There were early involvement and review of the airway by the anaesthetic and intensive care teams, which was deemed safe at the time. A plan was made for a definitive airway if bleeding reoccurred.Upper airway bleeding can present as a rare form of vape-induced injury and should be considered part of the differential diagnosis particularly in those using CBD oil vapes. History taking is pertinent and patients should be questioned on the specific vape liquids used. Airway stabilisation is the priority with early involvement of the multi-disciplinary team including anaesthetists, intensive care specialists and ENT surgeons.

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“…The proposed pathology explaining why vaping THC oil damages the lung is debated and poorly understood with no specific histopathological findings. This might be due to the direct impact of cannabinoid vapors or the inflammation from the diluting additives in the cartridges [ 4 ]. Most studies have shown that the most common diluting agent is vitamin-E acetate oil; harmless if used on topical application but would cause a severe inflammatory reaction in the lung parenchyma when inhaled, and it was detected in BAL samples from 48 out of 51 EVALI cases from 16 different states across the US [ 5 - 7 ].…”

Section: Discussionmentioning

confidence: 99%

COVID or Not COVID? A Great Mimicker Behind the Smoke Screen

Ayoub¹,

Quamme²,

Abdel-Reheem³

et al. 2021

Cureus

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Vaping is becoming increasingly popular as an alternative to cigarettes. However, vaping does not come without risks; electronic cigarette (e-cigarette) and vaping-associated lung injury (EVALI) is one of the most severe consequences. Coronavirus disease 2019 (COVID-19) and bacterial pneumonia cases often present with almost identical features. We present a case of a young man who presented with pneumonia that was initially thought to be related to COVID-19 infection but later diagnosed as EVALI. Clinicians should have a high suspicion of EVALI in patients who present with hypoxemia and negative infectious workup, particularly during the COVID-19 era. Administration of corticosteroids has shown remarkable efficacy in improving hypoxemia; however, many patients may have chronic lung injury and may require oxygen long-term. Cases of EVALI should continue to be reported and followed up long term for monitoring disease outcomes.

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A Case of Vaping TCH Oil Leading to Vaping Associated Pulmonary Injury: Our Approach to Its Diagnosis, Management, and Recommendations

Cited by 7 publications

References 6 publications

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Oropharyngeal Bleeding Due to Cannabidiol Oil Vape Use

COVID or Not COVID? A Great Mimicker Behind the Smoke Screen

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