Severe E-cigarette, or Vaping, Product Use Associated Lung Injury Requiring Venovenous Extracorporeal Membrane Oxygenation

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
Kim AldyImesha De Silva

Abstract

To report a severe case of e-cigarette or vaping product use-associated lung injury with complex course requiring venovenous extracorporeal membrane oxygenation. Case report. PICU in an academic medical center. A 16-year-old girl presenting with gastrointestinal and respiratory symptoms was admitted to our PICU after having progressive respiratory failure and bilateral pulmonary ground-glass opacities on chest CT. Venovenous extracorporeal membrane oxygenation MEASUREMENTS AND MAIN RESULTS:: After extensive infectious workup was unrevealing, she reported a history of vaping e-cigarette containing either nicotine or delta-9-tetrahydrocannabinol oil prior to symptom onset. She was given a presumptive diagnosis of e-cigarette or vaping product use-associated lung injury. The PICU team in consultation with pulmonology and medical toxicology started high-dose IV methylprednisolone 1 mg/kg bid. Despite initial improvements, she continued to require positive pressure ventilation and developed pneumomediastinum with progression to tension pneumothoraces and a persistent air leak. Unable to maintain her oxygenation, she was placed on venovenous extracorporeal membrane oxygenation for a prolonged course and had a tracheostomy placement. ...Continue Reading

References

Jun 13, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Winnie Hedevang OlesenPeter Bjørn Licht
Sep 7, 2019·The New England Journal of Medicine·Sean D MaddockScott K Aberegg
Sep 19, 2019·The New England Journal of Medicine·Richard MiechMegan E Patrick
Oct 3, 2019·The New England Journal of Medicine·Yasmeen M ButtBrandon T Larsen

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Citations

Oct 29, 2020·Pneumonia·Samuel H BelokHasmeena Kathuria
Sep 1, 2020·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Shawn J RiceChandra P Belani

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