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Lung. 2019 Oct 3. doi: 10.1007/s00408-019-00277-6. [Epub ahead of print]

Vaping-Associated Acute Respiratory Failure Due to Acute Lipoid Pneumonia.

Author information

1
Division of Critical Care Medicine, Department of Medicine, Einstein Division/Montefiore Medical Center, Albert Einstein College of Medicine, 1825 Eastchester Road, Bronx, NY, 10461, USA. pdicpin@gmail.com.
2
Division of Critical Care Medicine, Department of Medicine, Einstein Division/Montefiore Medical Center, Albert Einstein College of Medicine, 1825 Eastchester Road, Bronx, NY, 10461, USA.
3
Department of Pathology, Cytology Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Abstract

Electronic cigarettes, pens, cartridges and other devices were developed as nicotine delivery systems not requiring combustion of tobacco leaves. This technology was subsequently employed to deliver the cannabis component tetrahydrocannabinol (THC) via products often manufactured without adequate quality oversight and sold illegally. Recently, five patients presenting within a 2-month period with acute respiratory failure due to acute lipoid pneumonia after inhaling THC-containing concentrates or oils have been described. We report a 28-year-old previously healthy man who presented in acute respiratory failure 2 weeks after initiating use of a street-purchased THC-containing vape cartridge. Bronchoalveolar lavage cytology with oil red O staining confirmed the diagnosis of acute lipoid pneumonia. Diffuse alveolar hemorrhage and eosinophilic pneumonia were excluded. Evolving evidence supports a clinical entity of acute respiratory failure due to acute, exogenous lipoid pneumonia induced by THC-containing concentrates or oils inhaled through a variety of vaping products. All six patients reported to date received intravenous corticosteroids and survived to hospital discharge.

KEYWORDS:

Acute respiratory failure; Electronic cigarette; Lipoid pneumonia; Nicotine; Tetrahydrocannabinol (THC); Vaping

PMID:
31583455
DOI:
10.1007/s00408-019-00277-6

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