Woman, 19, put on ventilator after vaping leaves her lungs feeling like ‘broken glass’
A teen who was vaping and on the brink of death had to be put on a ventilator after e-cigarettes caused her lungs to become inflamed and patchy, indicating damage.
The 19-year-old girl went to the emergency room with abnormally high blood pressure, difficulty breathing, fever and a lack of oxygen in her blood.
She was initially diagnosed with severe bacterial pneumonia, which was treated with antibiotics.
But when antibiotics failed to improve her condition, doctors were baffled.
Scans showed translucent spots on her lungs, indicating that the lungs were full of fluid and that there were signs of tissue damage.
The scan of the patient’s lungs on the left shows hazy spots called vitreous opacities, which doctors initially mistook for signs of bacterial pneumonia.
Finally they asked her if she was an e-cigarette user and after ruling out Covid and bacterial pneumonia, her diagnosed with Lung injury due to the use of e-cigarettes or vaping products (EVALI).
EVALI has been a concern for years, as the number of young people using vapes has increased dramatically.
Public health reports indicate that approximately 2,800 patients were hospitalized for EVALI in 2020, 15 percent of whom were teenagers. This is the beginning of a small epidemic of EVALI cases in the U.S.
The young woman had symptoms for a week before going to the hospital, including high fever with chills, cough and shortness of breath at rest.
Before going to the hospital, she had been prescribed azithromycin, an antibiotic, for five days.
No CT or MRI scans were performed, so doctors couldn’t see the glassy spots or hazy areas in her lungs. They based their decision to prescribe the drug on her symptoms, which seemed to indicate a bacterial infection.
Glass opacities often occur alongside consolidation in the lungs. Consolidation refers to the thickening or swelling of lung tissue, which occurs when the air spaces in the lungs fill with fluid, pus, blood, or cells.
The morning she decided to go to the hospital, her breathing problems had reached a peak.
When she arrived, her heart rate was higher than normal, at 120 beats per minute, and her respiratory rate was elevated at 26 breaths per minute, higher than the normal range (60-100 beats per minute). The standard respiratory rate is about 12 to 20 breaths per minute.
E-cigarettes were first introduced in the US around 2007 and are now the most commonly used tobacco product among youth in the US. They are often marketed as a safer alternative to regular cigarettes.
She had a fever and doctors discovered she was hypoxemic, meaning her blood did not contain enough oxygen.
Doctors put her on a ventilator, gave her more antibiotics and gave her medicine to lower her fever.
However, when they saw no improvement after 48 hours, they ruled out bacterial pneumonia and Covid.
Given the perplexing nature of her case, a pulmonologist was called in, who eventually asked her if she used e-cigarettes.
The patient reported that she had been vaping e-cigarettes daily for the past month. They diagnosed her with lung damage caused by EVALI.
EVALI is a respiratory infection similar to other infections caused by inhaling toxic substances added to e-cigarette liquids that cause a chemical form of pneumonia.
EVALI is a diagnosis of exclusion because there are no clear criteria for it.
Imaging studies usually show hazy spots on the lungs.
Treatment consists of steroids, supplemented with supportive care with oxygen and complete cessation of e-vaping.
Patients usually respond well to steroid treatment and the prognosis is generally good after diagnosis.
According to a CDC research of a 2019 EVALI outbreak, vitamin E acetate may be the culprit. The compound has been found in product samples tested by the FDA and state labs, as well as in lung fluid samples from EVALI patients tested by the CDC in several states.
Interestingly, no vitamin E acetate was found in the lung fluid of individuals without EVALI.
Doctors gave the patient a high dose of a steroid called prednisone. Her respiratory symptoms improved and the signs of pneumonia decreased. Her blood oxygen levels also improved and she was able to leave the hospital.
She would recover well as long as she stayed away from vapes,
High-potency e-cigarettes are extremely addictive. Of all the teens who tried one, nearly half became regular users, according to the CDC
Doctors warned her not to start vaping again because the risk of EVALI striking again would be very high.
E-cigarettes were first introduced in the US around 2007 and are now the most commonly used tobacco product among youth in the US. They are often marketed as a safer alternative to regular cigarettes.
Among high school and college students, 2.8 million (10 percent) reported current use of a tobacco product such as a vape in 2023. Additionally, 2.13 million (7.7 percent) students reported current use of e-cigarettes in 2023.