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Clinical outcomes and lipid-laden macrophages in Electronic cigarette/Vaping product use-Associated Lung Injury(EVALI)in a South Texas population

引用

Discussion of Clinical Cases 2021年第1期8卷 1-6页

作者： Mahnoor Mir Moeezullah Beg Jay I.Peters Sandra G.Adams Department of Medicine UT Health San AntonioSan AntonioTXUSA Department of Medicine Pulmonary/Critical Care DivisionUT Health San AntonioSan AntonioTXUSA South Texas Veterans Health Care System San AntonioTXUSA

Objective:To describe the clinical features,proportion of lipid-laden alveolar macrophages in bronchoalveolar lavage(BAL),and short-term and 6-month to 12-month outcomes of patients with Electronic cigarette/Vaping product use-Associated Lung Injury(EVALI).Methods:Retrospective review of clinical characteristics,radiographs,and BAL samples for all patients with a history of vaping who presented with acute hypoxemic respiratory failure to the University Hospital in San Antonio,Texas from 9/2019 to 6/2020 was ***:We report 16 cases(15 men;median age,30 years[range 19-75])of EVALI with a history of vaping Tetrahydrocannabinol(THC),nicotine,or *** most common presenting symptoms were tachycardia,dyspnea,cough,and *** patients required supplemental oxygen,including two who required noninvasive positive pressure ventilation,and five who required mechanical *** 16 patients had bilateral ground-glass opacities(GGO)with peripheral sparing on chest computerized tomography(CT).Cultures were negative,except for one patient who tested positive for ***-19 PCR was done in one individual which was *** demonstrated lipid-laden macrophages on Oil-Red-O stain on fresh(i.e.,without fixative)BAL in the majority of patients(N=12)with a mean lipid-saturation percentage of 78%[range,44%-100%]and the mean Colombo count of 194[range,101-359].Fifteen patients were treated with systemic *** median length of hospital stay was 10 *** discharge,three patients required supplemental *** of those who had follow-up imaging showed resolution of *** patient had a relapse of symptoms and was again treated with systemic corticosteroids and mycophenolate,with resolution of *** patients who were evaluated after discharge denied vaping post-discharge(two patients were not able to be contacted and did not keep follow-up appointments).Conclusions:Successful diagnosis and management of EVALI requires

关键词： EVALI Vaping Acute lung injury lipid-laden macrophages Diffuse ground glass opacities

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