What is iVaps (inhaled vapors)?

Understanding iVaps (Inhaled Vapors)

iVaps (inhaled vapors) refers to the process of inhaling aerosolized particles produced by devices such as e-cigarettes, vaping devices, or medical nebulizers that convert liquid substances into small airborne particles for inhalation into the respiratory system.

Types of Inhaled Vapors

• Medical aerosols: Particles created by nebulizers derived from medication, used therapeutically for respiratory conditions 1
• Vaping aerosols: Refers to inhaling and exhaling aerosols produced by e-cigarettes, which usually contain nicotine (the addictive ingredient in tobacco) 1
• Fugitive aerosols: Aerosols released from nebulizers during patient expiration, including medicinal aerosols not inhaled by the patient but that pass into the atmosphere 1
• Bioaerosols: Exhaled aerosols comprised of small droplets of airway-lining fluid that can provide a vector for spreading infectious diseases 1

Medical Applications of Inhaled Vapors

• Nebulized medications: Used to deliver bronchodilators, antibiotics, pulmonary vasodilators, airway hydration, and mucolytics directly to the lungs 1
• Inhaled iloprost: A prostacyclin analog available for aerosol administration with a serum half-life of 20-25 minutes, used in pulmonary arterial hypertension 1
• Ipratropium bromide: An anticholinergic bronchodilator administered by oral inhalation with the aid of a nebulizer 2

Health Risks Associated with Inhaled Vapors

Medical Nebulization Risks

• Infection transmission: Nebulization may potentially increase the risk of transmitting respiratory infections through fugitive aerosols 1
• Occupational exposure: Healthcare workers may be exposed to hazardous drugs through inhalation of aerosols or gaseous vapors resulting from evaporation of hazardous drugs 1

Vaping Risks

• E-cigarette or vaping product-associated lung injury (EVALI): A serious condition linked to vaping that can cause respiratory failure 3, 4, 5
• Cardiovascular and respiratory effects: Vaping affects these systems, contradicting perceptions that e-cigarette use is harmless 6
• Toxic substances: Vaping products contain and emit numerous potentially toxic substances beyond just nicotine 6, 7
• Lung damage: Vapor-induced pulmonary lesions including bilateral ground glass opacities, infiltrates, pleural effusion, pneumomediastinum, and nodular opacities 7

Safety Considerations for Medical Nebulization

• Infection control: For in-hospital use, disposable nebulizers are suggested to address the potential risk of contamination 8
• Proper cleaning: After each use, rinse residual medication with sterile water, wipe the mouthpiece or face mask with an alcohol pad, and discard the nebulizer after 24 hours 8
• Home use precautions: Treatments should be administered in an area where the air is not recirculated or near an open window 8
• Device selection: A mouthpiece is preferred over a face mask to reduce fugitive aerosols 8

Regulatory and Public Health Perspectives

• E-cigarettes as cessation aids: Not approved as smoking cessation aids by regulatory agencies, unlike standard nicotine replacement therapies 6
• Public health concerns: The Forum of International Respiratory Societies recommends that electronic nicotine delivery devices should be restricted or banned until more information about their safety is available 6
• Passive exposure: Passive inhalation of vaporized droplets, particles, nicotine, and other substances into indoor air may have significant adverse health effects 6

Important Distinctions

• Vaping vs. smoking: While both involve inhalation, vaping refers specifically to inhaling aerosols from e-cigarettes, while smoking refers to inhaling smoke from combustible tobacco products 1
• Medical vs. recreational use: Medical nebulizers are designed specifically for therapeutic delivery of medications, while e-cigarettes and vaping devices are primarily used for recreational nicotine or THC delivery 1