Department of Pediatric Pulmonology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
Department of Radiology, Baylor College of Medicine, Houston, Texas, USA.
Pediatr Allergy Immunol Pulmonol. 2021 Mar;34(1):23-29. doi: 10.1089/ped.2020.1270.
In 2019, an alarming number of cases coined as e-cigarette, or vaping, product use-associated lung injury (EVALI) were described in adolescents ranging from mild respiratory distress to fulminant respiratory failure. Limited data have been published on outcomes at short-term follow-up. We aimed to describe pulmonary manifestations, function, and radiologic findings after corticosteroid therapy in a cohort of adolescent patients. A retrospective chart analysis of all patients presenting to our institution between July 2019 and December 2019 with EVALI was conducted. Patients who had pulmonary follow-up were included. Spirometry was performed before discharge from the hospital and during outpatient follow-up. A paired -test was used to compare serial spirometry data between visits. Eight patients (6 males) were included. Two patients required intubation with mechanical ventilation, 2 required bilevel positive airway pressure, and 3 required oxygen supplementation. All patients received glucocorticoids (3 receiving pulse dosing). Initial spirometry revealed decreased forced expiratory volume in one second and forced vital capacity with clinically and statistically significant improvement at follow-up (mean follow-up was 46.5 days). Radiographic manifestations also improved after vaping was discontinued. In our cohort of patients with EVALI, at short-term follow-up, all normalized their spirometry parameters and showed clinical resolution of symptoms.
在 2019 年,青少年中出现了大量被称为电子烟或蒸气产品使用相关肺损伤(EVALI)的病例,从轻度呼吸窘迫到暴发性呼吸衰竭不等。目前已经发表了一些关于短期随访结果的数据。我们旨在描述接受皮质类固醇治疗的青少年患者的肺部表现、功能和影像学发现。
对 2019 年 7 月至 2019 年 12 月期间在我院就诊的所有 EVALI 患者进行了回顾性图表分析。包括进行了肺部随访的患者。在出院前和门诊随访期间进行了肺量测定。采用配对 t 检验比较两次就诊时的系列肺量测定数据。
共纳入 8 例患者(6 名男性)。2 例患者需要插管机械通气,2 例需要双水平正压通气,3 例需要氧疗。所有患者均接受了糖皮质激素治疗(3 例接受脉冲治疗)。初始肺量测定显示 1 秒用力呼气量和用力肺活量降低,随访时临床和统计学均有显著改善(平均随访时间为 46.5 天)。停止蒸气后,影像学表现也有所改善。
在我们的 EVALI 患者队列中,短期随访时,所有患者的肺量测定参数均正常,症状得到临床缓解。