Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA.
J Med Toxicol. 2020 Jul;16(3):248-254. doi: 10.1007/s13181-020-00765-9. Epub 2020 Mar 19.
E-cigarette, or vaping, product use associated lung injury (EVALI) has become a recent concern among public health officials. Factors that contribute to the concern include an increasing number of cases over time, the severity of the illness, and an unknown understanding of the pathophysiology and etiology of the illness.
We cared for three adolescent patients with acute respiratory failure secondary to EVALI. All three patients were treated with high-dose steroids in addition to antimicrobials, which resulted in clinical improvement and resolution of their respiratory failure. Pulmonary function testing was performed on these previously healthy patients both acutely and subacutely. Additionally, we report the results from the laboratory analysis of one vaping device fluid which revealed previously unpublished components within these products.
EVALI is a recent public health concern without a known etiology which can cause life-threatening lung injury in patients without prior lung pathology. We hope these cases will highlight the importance of return precautions in adolescents with vague respiratory symptoms and provide a cautionary tale to providers while they counsel patients regarding the use of these products.
电子烟或蒸气烟产品相关肺损伤（EVALI）已成为公共卫生官员近期关注的问题。导致人们关注的因素包括随时间推移病例数量不断增加、疾病的严重程度，以及对疾病病理生理学和病因学的未知理解。
我们治疗了三例因 EVALI 导致急性呼吸衰竭的青少年患者。所有三名患者除了接受抗生素治疗外，还接受了大剂量类固醇治疗，这导致他们的临床症状改善，呼吸衰竭得到解决。我们对这些之前健康的患者进行了急性和亚急性肺功能测试。此外，我们报告了一份蒸气烟装置液体的实验室分析结果，该结果揭示了这些产品中以前未公布的成分。
EVALI 是一个近期的公共卫生问题，其病因不明，可导致无先前肺部疾病的患者发生危及生命的肺部损伤。我们希望这些病例将突出青少年出现模糊呼吸道症状时采取回溯预防措施的重要性，并为提供者在就这些产品的使用为患者提供咨询时敲响警钟。
