Increased Reports of Vaping Dangers

In the last few weeks, the Pittsburgh Poison Control Center has been hearing increasing reports of lung injury which may be associated with vaping.

Acute lung injury, simply put, “is a serious complication and can result in severe respiratory distress including the possible need for mechanical ventilation,” according to Dr. Angelo Illuzzi, pulmonologist and sleep medicine physician at Penn Highlands Healthcare. In Pittsburgh, the injuries have been severe enough that patients have needed mechanical ventilators to breathe.

These incidents have led to a statewide request from the state Department of Health asking all healthcare workers to be aware of this situation. In turn, Penn Highlands Healthcare would like to share this information, too.

What is vaping? Vaping is the term used for the use of e-cigarettes. E-cigarettes heat nicotine extracted from tobacco along with added flavorings and other chemicals to create a water vapor that is inhaled. Vaping is often advertised as a way to decrease smoking tobacco, but e-cigarettes have not received federal Food and Drug Administration approval as a smoking cessation device. E-cigarettes are also used to create a vapor to ingest TCH, tetrahydrocannabinol, or the psychoactive part of cannabis.

As e-cigarettes are still fairly new, scientists are still learning about the long-term health effects on the lungs.

Recently, the Department of Health, or DOH, became aware of at least four cases of lung injury that have been treated in Pittsburgh hospitals in the last couple of weeks that appear to be related to vaping, though the specific products are unknown at this time.

Though a study wasn’t done to define the relationship between vaping and the injuries, “the association is strong,” the DOH said. Specialists from the Pittsburgh Poison Center are working with a multidisciplinary team of physician experts to identify cases and investigate with the DOH and the Centers for Disease Control & Prevention, or CDC.

Reported symptoms and findings in cases of suspected vaping associated lung injury have included:

• Fever, nausea, vomiting;
• Shortness of breath, cough and chest pain;
• Both lungs showing an abnormal substance and abnormal haziness on lung x-rays;
• Progression of symptoms over several days similar to a viral illness.

Providers across the state are told to be aware of the potential for significant lung injury in patients presenting with lung symptoms or otherwise appearing to have a virus. “If a patient has a history of vaping, perform a careful pulmonary examination and provide patient education regarding the potential for severe lung injury,” the DOH said.

In patients with lung injury without an apparent alternative cause, providers will obtain a detailed history of vaping activity, the device used, the products used and where the product was purchased.
Providers will also be looking for data on x-rays and CT scans along with lab tests to see what the person may have inhaled – maybe even unknowingly.

At this time, there is not one course of treatment for the injuries. The goal is to keep patients breathing as some reported cases have required mechanical ventilation or use of a heart-lung machine.
If someone is using e-cigarettes and is noticing any breathing problems, he or she should seek medical care.

“Practice good lung health and avoid any inhalant such as cigarettes, spray cans and vaping products,” Illuzzi said. “The only thing that should go in your lungs is clean fresh air!”