E-cigarette or vaping product use-associated lung injury

Area of Science:

• Pulmonology
• Toxicology
• Public Health

Background:

• E-cigarette or vaping product use-associated lung injury (EVALI) is an acute pulmonary syndrome.
• EVALI emerged in the USA in 2019, primarily affecting young men with severe lung consolidation and respiratory failure.
• The condition has a reported mortality rate of approximately 2%.

Purpose of the Study:

• To review the recent literature on EVALI, focusing on clinical features, presentation, and investigations.
• To explore possible mechanisms of lung injury in the context of vaping practices.
• To compare vaping practices and reported EVALI cases in the USA and the UK.

Main Methods:

• Literature review of clinical studies and reports on EVALI.
• Analysis of clinical features, diagnostic findings, and patient demographics.
• Examination of potential etiological agents, including vitamin E acetate in cannabis-containing vape products.

Main Results:

• EVALI is strongly associated with vaping, especially unlicensed cannabis products containing tetrahydrocannabinol (THC).
• Vitamin E acetate, a solvent in some THC vape products, has been identified in bronchoalveolar lavage fluid of affected patients.
• The syndrome presents acutely with severe pulmonary consolidation, often leading to respiratory failure.

Conclusions:

• The exact cause of EVALI remains unknown but is linked to specific vaping practices and additives.
• Vitamin E acetate is a key suspect agent implicated in the pathogenesis of EVALI.
• Further research is needed to understand the full spectrum of EVALI and inform public health strategies.