Physiologic Effects, Health Screening, and Anesthetic Management of Patients Who Vape: A Narrative Review

Compelling evidence points to a meteoric rise in e-cigarette (EC) usage throughout the United States. Since its debut, electronic vapor delivery systems have become a significant social trend, particularly among young people. Presently, 3.6 million teenagers and 10.8 million adults use ECs, with a proliferation of utilization increasing from 0.6% in 2011 to 11.3% in 2017 and from 2.4% to 6% in adolescents and adults, respectively. EC usage is associated with the development of product usage-related lung injury. ECs increase the probability of ventilatory complications and have adverse effects on the respiratory system, including enhanced metabolic stress, impeded lung development, and weakened immunity. A targeted preoperative screening method that evaluates vaping users, level of consumption, usage behaviors, and nicotine concentrations will enhance the clinical respiratory assessment. A systematic search of five databases was conducted, employing MeSH terms and Boolean logic. With the use of automation, 22 studies were identified, including seven randomized controlled trials, four quasi-experimental studies, 10 observational studies, and a quality improvement project. Evidence synthesis elucidates the need to tailor perioperative management to the systematic alterations electronic cigarettes impose.