Acute Respiratory Failure Associated With Vaping

Chest. 2020 Mar;157(3):e63-e68. doi: 10.1016/j.chest.2019.10.057.

Abstract

The use of e-cigarettes to deliver aerosolized nicotine has gained popularity in recent years. Numerous reports have cited the development of acute pulmonary disease linked to vaping nicotine as well as marijuana-based products. As cultural attitudes evolve and policies shift toward the legalization of marijuana, its use has become more prevalent. Given the increased prevalence of marijuana consumption and e-cigarette usage, better insight into its potential to cause lung toxicity is warranted. The clinical, radiographic, and histopathologic characteristics of lung injury associated with vaping, particularly with marijuana-based products, have yet to be well described in the literature. We present eight patients, most of whom were admitted recently to our institution with acute respiratory failure following vaping. The majority of patients were young, with a median age of 31.5 years (range, 24-62 years) and with no known underlying lung disease. This case series highlights common clinical findings as well as the varied radiographic and histopathologic features of acute respiratory failure associated with vaping predominantly marijuana-based products. As more cases of vaping-associated pulmonary injury unfold, data will be available to further characterize this emerging disease entity. Improved understanding of disease pathogenesis and its clinical course will help clinicians determine optimal management and follow-up strategies for this patient population.

Keywords: interstitial lung disease; marijuana; pulmonary; respiratory failure; smoking.

MeSH terms

  • Acute Disease
  • Adult
  • Alveolar Epithelial Cells / pathology
  • Anti-Bacterial Agents / therapeutic use
  • Blood Sedimentation
  • Bronchoalveolar Lavage Fluid
  • C-Reactive Protein / immunology
  • Cough / etiology
  • Dyspnea / etiology
  • Electronic Nicotine Delivery Systems
  • Female
  • Fever / etiology
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyperplasia
  • Hypoxia / etiology
  • Lung / diagnostic imaging
  • Lung / pathology
  • Male
  • Marijuana Use*
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Respiratory Insufficiency / etiology*
  • Respiratory Insufficiency / immunology
  • Respiratory Insufficiency / therapy
  • Tomography, X-Ray Computed
  • Vaping / adverse effects*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • C-Reactive Protein
  • Methylprednisolone