Vaping-Associated Respiratory Distress Syndrome: Case Classification and Clinical Guidance

Abstract

Exposure to vaping is associated with a growing list of respiratory syndromes including an acute progressive form with life-threatening hypoxemic respiratory failure and pathologic changes of lung injury termed vaping-associated respiratory distress syndrome.

Data sources: Center from Disease Control, Departments of Public Health, MEDLINE (via PubMed), and the Cochrane Library.

Study selection data extraction and data synthesis: Cases, series, and public health reports of cases that met the Centers for Disease Control and Prevention case definition of vaping-associated respiratory disease were extracted by an author with perfect verification by a second. Cases were classified on the basis of toxin exposure, symptoms, oxygen saturation, progression to respiratory failure, and pathologic features, and a clinically actionable system of classification was based on expert opinion.

Conclusions: The reported spectrum of vaping-associated respiratory diseases allows clinical classification of cases into groups with distinct evaluation, management, and recommendations for prevention and follow-up. Clinical stratification also identifies a small proportion of vaping-exposed patients who are at risk for progression to hypoxemic respiratory failure and an acute respiratory distress syndrome-like illness.

Keywords: acute respiratory distress syndrome; e-cigarette; respiratory failure; review; vape.