From the Guidelines
Treatment for vaping-induced lung injury (EVALI) should primarily involve supportive care, corticosteroids, and immediate cessation of vaping and e-cigarette use. The approach to treating EVALI is largely based on the principles of managing acute respiratory distress syndrome (ARDS) and other diffuse lung diseases, as outlined in recent research 1. Key components of treatment include:
- Supportive care with supplemental oxygen therapy based on oxygen saturation levels
- Corticosteroids, such as methylprednisolone or prednisone, to reduce lung inflammation
- Empiric antibiotics, like azithromycin, until infection is ruled out
- Respiratory support, which may include mechanical ventilation or non-invasive ventilation methods
- Close follow-up after discharge, with recommended pulmonary function testing at 1-2 months
The use of corticosteroids is particularly important, as they can effectively reduce the inflammatory response triggered by vaping chemicals that damage lung tissue 1. It is essential to recognize the underlying cause of lung injury, as adequate treatment of the underlying disease is a fundamental aspect of ARDS care, including EVALI 1. By prioritizing supportive care, corticosteroids, and cessation of vaping, patients with EVALI can experience significant improvement within weeks to months of treatment initiation.
From the Research
Treatment Options for Vaping-Induced Lung Injury
The treatment options for vaping-induced lung injury are primarily focused on supportive care and managing symptoms. Some key points to consider include:
- Aggressive supportive care, including mechanical ventilation and oxygen supplementation, is often necessary for severe cases 2, 3, 4.
- Systemic corticosteroids may be considered as a therapeutic adjunct in vaping-associated lung injury 2, 3, 4.
- N-acetyl cysteine may also be considered as a therapeutic adjunct in vaping-associated lung injury 2.
- Avoidance of vaping products is crucial in the treatment and management of vaping-induced lung injury 3, 5, 6.
Clinical Presentation and Diagnosis
Vaping-induced lung injury can present with a range of symptoms, including:
- Respiratory symptoms such as dyspnea and cough 2, 3, 4, 5, 6.
- Constitutional symptoms such as fever and fatigue 3, 5, 6.
- Gastrointestinal symptoms such as nausea and vomiting 3, 5, 6.
- Radiological findings of lung injury, including bilateral ground-glass opacities on chest imaging 2, 3, 4, 5, 6.
Prognosis and Outcomes
The prognosis for vaping-induced lung injury appears to be favorable with aggressive supportive care, although mortality rates may rise with increasing disease severity 2, 3. Long-term outcomes are not yet fully understood, and further research is needed to determine the potential long-term complications of vaping-induced lung injury 2, 5.