Clinical Features of E-cigarette, or Vaping, Product Use-Associated Lung Injury in Teenagers.
Clinical Features of E-cigarette, or Vaping, Product Use-Associated Lung Injury in Teenagers.
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DOI：
10.1542/peds.2019-4104
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发表时间：
2020-07
期刊：
影响因子：
8
通讯作者：
Mittal V
中科院分区：
文献类型：
--
作者：
Rao DR;Maple KL;Dettori A;Afolabi F;Francis JKR;Artunduaga M;Lieu TJ;Aldy K;Cao DJ;Hsu S;Feng SY;Mittal V
2019年，美国爆发了电子烟或电子烟产品使用相关的肺损伤（EVALI）。EVALI在青少年中的表现尚未得到很好的表征。我们描述的诊断，评估和管理的EVALI在青少年住院的三级保健，大学附属儿童医院。一个多学科委员会根据疾病控制和预防中心的指导方针开发了EVALI算法。对诊断为EVALI的患者进行了回顾性病历审查。描述性分析包括社会人口学特征、临床表现、实验室和影像学结果、肺功能检查、需氧量和临床随访。13名住院青少年被诊断为确诊或可能的EVALI。大多数为女性（54%），平均年龄为15.9岁。69%的患者出现呼吸道症状，而85%的患者的胃肠道症状突出。92%的患者报告了Δ-9-四氢大麻酚，62%的患者报告了尼古丁。所有患者在胸部计算机断层扫描（CT）上均有双侧毛玻璃样阴影。糖皮质激素治疗导致12例患者中11例临床改善。糖皮质激素治疗导致1秒用力呼气量和用力肺活量的改善（P <0.05）。根据6分钟步行试验结果，4名患者需要家庭吸氧。EVALI的诊断应根据吸烟史和临床表现进行怀疑。糖皮质激素治疗导致症状和肺功能改善。6分钟步行试验可能有助于确定出院时的氧气需求。
In the United States in 2019, there was an outbreak of electronic cigarette, or vaping, product use–associated lung injury (EVALI). The manifestations of EVALI in adolescents are not well characterized. We describe the diagnosis, evaluation, and management of EVALI in adolescents hospitalized at a tertiary care, university-affiliated children’s hospital. A multidisciplinary committee developed an EVALI algorithm on the basis of guidelines from the Centers for Disease Control and Prevention. A retrospective chart review was conducted on patients diagnosed with EVALI. Descriptive analyses included sociodemographic characteristics, clinical presentation, laboratory and imaging results, pulmonary function testing, oxygen requirements, and clinic follow-up. Thirteen hospitalized adolescents were diagnosed with confirmed or probable EVALI. The majority were female (54%) with a mean age of 15.9 years. Sixty-nine percent of patients presented with respiratory symptoms, whereas gastrointestinal symptoms were prominent in 85% of patients. Vaping Δ−9-tetrahydrocannabinol was reported in 92% of patients, and vaping nicotine was reported in 62% of patients. All had bilateral ground-glass opacities on the chest computed tomography (CT) scan. Treatment with glucocorticoids led to clinical improvement in 11 of 12 patients. Treatment with glucocorticoids led to improvement in both forced expiratory volume in 1 second and forced vital capacity (P < .05). Four patients required home oxygen on the basis of 6-minute walk test results. Diagnosis of EVALI should be suspected on the basis of vaping history and clinical presentation. Glucocorticoid treatment led to an improvement in symptoms and lung function. The 6-minute walk test may help determine oxygen needs at discharge.
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影响因子：
33.9
作者：
Blount, Benjamin C.;Karwowski, Mateusz P.;Pirkle, James L.
通讯作者：
Pirkle, James L.
影响因子：
24
作者：
Douwes, Johannes M.;Humpl, Tilman;Berger, Rolf M. F.
通讯作者：
Berger, Rolf M. F.
DOI：
10.1152/ajplung.00389.2017
发表时间：
2018-11-01
影响因子：
4.9
作者：
Glynos, Constantinos;Bibli, Sofia-Iris;Papapetropoulos, Andreas
通讯作者：
Papapetropoulos, Andreas
影响因子：
6.9
作者：
Lappas, Andreas S.;Tzortzi, Anna S.;Behrakis, Panagiotis K.
通讯作者：
Behrakis, Panagiotis K.
影响因子：
8
作者：
McMillen, Robert;Tanski, Susanne;Winickoff, Jonathan P.
通讯作者：
Winickoff, Jonathan P.