Vaping Associated Pulmonary Injury

Abstract

Vaping-associated pulmonary injury (VAPI) is a newly evolving medical condition caused by inhalation of substances including tetrahydrocannabinol- or nicotine-containing products via vaping. Vaping is the act of inhaling and exhaling an aerosol, which can contain fine particles that have been identified as toxic chemicals, produced by an e-cigarette or similar device. Presenting symptoms of VAPI include respiratory symptoms (dyspnea, chest pain, cough, and hypoxia), gastrointestinal symptoms (nausea, emesis, diarrhea, and abdominal pain), and constitutional symptoms (fever, chills, weight loss, and fatigue). The diagnosis and management of VAPI are being studied and it is considered a diagnosis of exclusion. Most patients are young, with male predominance, and history of vaping. The severity of presenting symptoms varies. Radiographic findings vary in severity with chest x-rays showing bilateral infiltrates, although those findings may be absent early in the disease course. Computed tomography of the chest can show bilateral ground-glass opacities with pleural effusions and pneumomediastinum. Management of VAPI is based upon clinical presentation with empiric antibiotics for CAP coverage and steroids if indicated for reducing lung inflammation.