E-cigarette, or vaping, product use-associated lung injury: a review.
E-cigarette, or vaping, product use-associated lung injury: a review.
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DOI：
10.1186/s41479-020-00075-2
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Kathuria H
中科院分区：
文献类型：
--
作者：
Belok SH;Parikh R;Bernardo J;Kathuria H
电子烟，或Vaping，产品烟雾相关肺损伤（EVALI）是一种与使用电池供电或过热设备相关的疾病实体，这些设备会产生尼古丁和四氢大麻酚（THC）和/或其他吸入物质的雾化形式。我们进行了文献回顾，以记录流行病学，发病机制和危险因素，诊断，临床表现，评估和管理EVALI。在2019年夏天，EVALI病例的爆发使这种疾病实体成为全国关注的焦点。自被认定为具有公共卫生影响的严重肺病以来，截至2020年2月，CDC已报告2600多例病例，其中68例死亡。EVALI的病理生理学尚不清楚。维生素E醋酸酯等物质被认为是肺损伤的可能原因。疾病预防控制中心已经建立了“确认EVALI”病例的病例定义，以帮助指导疾病的识别和协助监测。虽然医疗保健提供者的临床判断在EVALI病例的识别中至关重要，但EVALI的异质性表现也使其难以识别。最终，大多数调查性研究的目的应该是排除其他可能出现类似情况的疾病过程。治疗的中心是去除有害物质和提供支持性护理。EVALI是一种具有公共卫生影响的严重肺部疾病。诊断需要高度怀疑，以诊断和排除其他可能的肺部疾病的原因。这可能是有益的，涉及肺专科医生在早期管理这种疾病，这通常是支持性治疗。
E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) is a disease entity related to the use of battery-operated or superheating devices that create an aerosolized form of nicotine and tetrahydrocannabinol (THC) and/or other substances for inhalation. We performed a literature review to document epidemiology, pathogenesis and risk factors, diagnosis, clinical presentation, evaluation and management of EVALI. In the summer of 2019, an outbreak of EVALI cases brought this disease entity into the national spotlight. Since being recognized as a serious pulmonary disease with public health implications, more than 2600 cases have been reported to CDC with 68 deaths as of February 2020. The pathophysiology of EVALI remains unknown. Substances such as Vitamin E acetate have been implicated as a possible causes of lung injury. The CDC has established case definitions of “confirmed EVALI” cases to help guide identification of the disease and assist in surveillance. While clinical judgement by healthcare providers is imperative in the identification of EVALI cases, the heterogeneous presentations of EVALI make this difficult as well. Ultimately most investigative studies should be aimed at ruling out other disease processes that can present similarly. Treatment is centered around removing the offending substance and providing supportive care. EVALI is a serious pulmonary disease with public health implications. Diagnosis requires a high degree of suspicion to diagnose and exclusion of other possible causes of lung disease. It may be beneficial to involve a pulmonary specialist early in the management of this disease which is generally supportive care.
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