Department of Anaesthesiology and Intensive Therapy, Provincial Hospital in Bielsko-Biala, Poland.
Faculty of Health Sciences, University of Technology and Humanities in Bielsko-Biała, Poland.
Anaesthesiol Intensive Ther. 2020;52(3):219-225. doi: 10.5114/ait.2020.97989.
Based on the data currently available in literature, the factors inducing acute lung injury resulting from the increasingly widespread use of e-cigarettes (vaping) (EVALI) were analysed. Although the number of traditional smokers in the population has been declining, vaping may be dangerous to health due to the substances contained in various e-cigarette liquids and cause acute respiratory failure during various forms of pneumonitis. In addition to tetrahydrocannabinol (THC), cannabidiol (CB) and other opioids, the major injuring factors include standard ingredients of e-liquid, such as propylene glycol, vegetable glycerine, colouring dyes, and flavouring agents. Vaping-associated lung injury impairs the alveolar-capillary barrier and distribution of respiratory volume manifesting the features of atelectasis, which is particularly pronounced in lipoid pneumonia. Due to critical gas exchange disorders, ICU treatment is required in an increasing number of patients. The management is essentially based on steroid and antibiotic therapy; whenever the ventilator is needed, the principles of lung-protective ventilation should be strictly followed. If mechanical ventilation fails, ECMO should be considered.
基于目前文献中可用的数据，分析了电子烟（ vaping）（EVALI）日益广泛使用导致急性肺损伤的因素。尽管人群中传统吸烟者的数量一直在下降，但由于各种电子烟液体中所含的物质，以及在各种形式的肺炎中引起急性呼吸衰竭，vape 可能对健康有害。除了四氢大麻酚（THC）、大麻二酚（CB）和其他阿片类药物外，主要的损伤因素还包括电子液体的标准成分，如丙二醇、植物甘油、着色染料和调味剂。与 vaping 相关的肺损伤会损害肺泡毛细血管屏障和呼吸量的分布，表现出肺不张的特征，在类脂性肺炎中尤为明显。由于严重的气体交换障碍，越来越多的患者需要 ICU 治疗。治疗主要基于类固醇和抗生素治疗；只要需要呼吸机，就应严格遵循肺保护通气的原则。如果机械通气失败，应考虑使用 ECMO。
