Spontaneous pneumomediastinum secondary to electronic cigarette use

Burgwardt, Sean; Huskic, Arnes; Schwartz, Gary S.; Mason, David P.; Tapias, Leonidas; Podgaetz, Eitan

doi:10.1080/08998280.2020.1717407

Cited by 10 publications

(12 citation statements)

References 1 publication

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“…It appears that the composition of the e-liquid and repeated dosing or vaping “behavior” may be responsible for the observed toxicity. Burgwardt et al ( 2020 ) reported that Valsalva vaping may enhance exposure to harmful constituents such as flavoring in the EC aerosol vaper. Valsalva vaping is achieved when EC users over-inhale and then forcefully exhale to eliminate the vapor, which is usually produced in greater quantities than that generated by a conventional cigarette.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary effects of e-liquid flavors: a systematic review

Effah¹,

Taiwo

Baines

et al. 2022

Journal of Toxicology and Environmental Health, Part B

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Electronic cigarettes (ECs) are purported to be tobacco harm-reduction products whose degree of harm has been highly debated. EC use is considered less hazardous than smoking but is not expected to be harmless. Following the banning of e-liquid flavors in countries such as the US, Finland, Ukraine, and Hungary, there are growing concerns regarding the safety profile of e-liquid flavors used in ECs. While these are employed extensively in the food industry and are generally regarded as safe (GRAS) when ingested, GRAS status after inhalation is unclear. The aim of this review was to assess evidence from 38 reports on the adverse effects of flavored e-liquids on the respiratory system in both in vitro and in vivo studies published between 2006 and 2021. Data collected demonstrated greater detrimental effects in vitro with cinnamon (9 articles), strawberry (5 articles), and menthol (10 articles), flavors than other flavors. The most reported effects among these investigations were perturbations of pro-inflammatory biomarkers and enhanced cytotoxicity. There is sufficient evidence to support the toxicological impacts of diacetyl- and cinnamaldehyde-containing e-liquids following human inhalation; however, safety profiles on other flavors are elusive. The latter may result from inconsistencies between experimental approaches and uncertainties due to the contributions from other e-liquid constituents. Further, the relevance of the concentration ranges to human exposure levels is uncertain. Evidence indicates that an adequately controlled and consistent, systematic toxicological investigation of a broad spectrum of e-liquid flavors may be required at biologically relevant concentrations to better inform public health authorities on the risk assessment following exposure to EC flavor ingredients.

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Section: Introductionmentioning

confidence: 99%

Pulmonary effects of e-liquid flavors: a systematic review

Effah¹,

Taiwo

Baines

et al. 2022

Journal of Toxicology and Environmental Health, Part B

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“…Three similar vaping-induced pneumomediastinum cases have been reported in the literature so far [7][8][9].…”

Section: Discussionmentioning

confidence: 67%

“…Burgwardt et al presented a 25-year-old male with no past medical history presented with chest pain with a diagnosis of SPM. The patient had a history of vaping and at a social gathering, he utilized his e-cigarette in much greater frequency than normal [ 8 ]. Alam et al presented a case of the spontaneous mediastinum in a 22-year-old male patient with a history of vaping and no past medical history.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Vaping-Induced Spontaneous Pneumomediastinum

Adhikari

Manduva

Malayala

et al. 2021

Cureus

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Vaping is the process of inhaling an aerosol produced by heating a liquid or wax containing substances such as nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol). The presence of air or gas in the mediastinum is pneumomediastinum.We present a rare case of vaping-induced spontaneous pneumomediastinum. A young 20-year-old female patient with a history of vaping and no past medical history presented with acute chest pain to an emergency room. The urine drug screen was positive for cannabinoids. Imaging studies -chest x-ray and computed tomography of the chest -showed pneumomediastinum. The patient was discharged after a day of observation and counseling to quit vaping.

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“…Pneumomediastinum occurs as a result of an increase in intrathoracic pressure, which results in air leakage from the alveoli [70]. Vaping-related behaviors such as deep inhalation [71], increased frequency of use [72], and a strong cough [73]…”

Section: Spontaneous Pneumomediastinummentioning

confidence: 99%

Acute Health Consequences from Electronic Cigarettes: A Narrative Review

Laohaprapanon

Saengow

2022

PPASB

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Electronic cigarettes (e-cigarettes) is relatively recently introduced to the market. Its long-term effects are still unclear and require years of research. On the other hand, knowledge about the short-term effects of e-cigarettes is emerging. The purpose of this review was to examine the current literature on the acute health consequences associated with the e-cigarette. We used pre-specified keywords to conduct searches in academic databases of articles published between 2011 and 2020. This review focused on acute health consequences of e-cigarettes in humans that can be directly attributed to the e-cigarette. Burns and injuries associated with device explosion, e-liquid intoxication, e-cigarette or vaping product use-associated lung injury, and pneumomediastinum were identified as acute health consequences associated with e-cigarettes. Except for pneumomediastinum, these acute health consequences are unique to an e-cigarette that are unlikely to be caused by a conventional cigarette. In the short term, the e-cigarette is likely more harmful than the conventional cigarette. Tightening safety regulations on the manufacturing, distribution, and sale of e-cigarette devices is recommended. Compulsory child-resistant containers for e-liquid containers, banning or restriction the use of colorful labels on e-liquid containers, and compulsory warning labels on e-liquid containers are recommended to prevent child’s ingestion of e-liquid.

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Spontaneous pneumomediastinum secondary to electronic cigarette use

Cited by 10 publications

References 1 publication

Pulmonary effects of e-liquid flavors: a systematic review

Pulmonary effects of e-liquid flavors: a systematic review

A Rare Case of Vaping-Induced Spontaneous Pneumomediastinum

Acute Health Consequences from Electronic Cigarettes: A Narrative Review

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