Cannabis Smoking-induced Diffuse Alveolar Hemorrhage

Alqahtani, Ali; Ammari, Zaid; Ramahi, Ahmad; Ahmed, Tamer Said; Klada, Emile

doi:10.7759/cureus.5089

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…The immediate effects of oral or inhaled THC induces bronchodilation both in healthy subjects and those with asthma,220 221 but aerosolized THC or cannabis smoking may also result in an irritation of the airways and bronchoconstriction in some individuals with reactive airway disease 222. Evidence of harm is limited to small case series and case reports 212 223–229. A small clinical trial and several case reports of patients with acute shortness of breath and hemoptysis within hours of cannabis use have been published 230–233.…”

Section: Methodsmentioning

confidence: 99%

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

Shah

Schwenk

Sondekoppam

et al. 2023

Reg Anesth Pain Med

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BackgroundThe past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear.MethodsIn November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A consensus recommendation required ≥75% agreement.ResultsNine questions were selected, with 100% consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes.ConclusionsSpecific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.

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Section: Methodsmentioning

confidence: 99%

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

Shah

Schwenk

Sondekoppam

et al. 2023

Reg Anesth Pain Med

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“…Both mechanisms cause shear damage and air leakage along bronchovascular bundle into the mediastinum [ 2 ]. In addition to barotrauma, inhalation injury can result in airway inflammation, edema, and increased alveolar permeability resulting in alveolar damage [ 3 ]. Bronchoscopic studies from habitual smokers have demonstrated destruction of ciliated columnar epithelial cells with replacement by mucus secreting goblet cells, resulting in increased mucus production and impaired mucociliary clearance, hence predisposing individuals to bronchitis and pneumonia [ 4 ] Cyclical vomiting is also a contributing factor as seen in our patient.…”

Section: Discussionmentioning

confidence: 99%

Marijuana induced spontaneous pneumomediastinum

Puri

Rhee

Harish

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

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Spontaneous pneumomediastinum (SPM), a rare occurrence, is defined by the presence of extraluminal gas in the mediastinum in the absence of trauma or underlying parenchymal disease. It is usually benign and has been associated with the inhalation of marijuana, cocaine, and amphetamines. The breathing maneuvers along with cyclical vomiting have been postulated as the underlying etiology. We present a case of a 27-year-old previously healthy male who presented with sudden onset chest pain and was found to have marijuana-induced pneumomediastinum.

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“…In addition to the anticoagulatory effects observed with the abovementioned plantderived cannabinoids, diffuse alveolar hemorrhage and hemoptysis have also been linked to cannabis smoking [54][55][56], which may suggest an anticoagulatory activity of some components of cannabis. In these cases; however, the exact contents of the smoked cannabis are unknown, and the underlying mechanisms of the bleeding remain to be elucidated.…”

Section: Anticoagulatory Effects Of Cannabinoidsmentioning

confidence: 99%

The Endocannabinoid System: A Potential Therapeutic Target for Coagulopathies

Khayat

Lehmann

2022

Metabolites

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Abnormal blood coagulation or coagulopathy is a common manifestation of many pathological conditions. It occurs when there is an imbalance between the activities of the coagulation system and the fibrinolytic system, leading to excessive or impaired intravascular blood clot formation, which can disturb blood flow causing ischemia or hemorrhage in the affected tissues. A growing body of evidence has demonstrated blood coagulation abnormalities in association with cannabinoid use, suggesting the involvement of the endogenous cannabinoid system (ECS) in modulating blood coagulation. However, the evidence in the literature has been controversial on whether cannabinoids promote or inhibit blood coagulation. The ECS has been extensively studied in recent years for its potential as a therapeutic target for many diseases. This review provides a brief introduction to the ECS and discusses the reported anticoagulatory and procoagulatory effects of various cannabinoids, highlighting some possible mechanisms that might underlie the observed effects. Understanding the coagulatory effects of cannabinoids and the interaction between the coagulation system and the ECS is vital for developing novel therapeutics for coagulopathies.

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Cannabis Smoking-induced Diffuse Alveolar Hemorrhage

Cited by 10 publications

References 9 publications

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids

Marijuana induced spontaneous pneumomediastinum

The Endocannabinoid System: A Potential Therapeutic Target for Coagulopathies

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