Nelson Textbook of Pediatrics 22nd Edition | Acute lung injury associated with e-cigarette or vaping product use. Outbreak peaked 2019-2020. Median age 21 years (range 13-85). ~90% used THC-containing products, many from black market sources. Pathophysiology: airway-centered chemical pneumonitis; vitamin E acetate (diluent) implicated as a causative agent. Clinical: respiratory (cough, dyspnea, hemoptysis, chest pain), gastrointestinal (nausea, vomiting, diarrhea, abdominal pain), constitutional (fever, chills, weight loss). Diagnosis: history of vaping within 90 days, CXR/CT (bilateral ground-glass opacities, subpleural sparing), exclusion of infection. Treatment: supportive care, supplemental oxygen, systemic corticosteroids (methylprednisolone), avoid re-exposure. Prevention: avoid e-cigarettes/vaping, FDA regulation of products.
🌐 paeds.online — Pakistan's Pediatric Platform| Severity | Management |
|---|---|
| Mild (SpO2 ≥95%, no respiratory distress) | Outpatient: cessation of vaping, close follow-up, consider oral corticosteroids if persistent symptoms |
| Moderate (SpO2 90-94%, mild distress) | Admit, oxygen, IV methylprednisolone (1-2 mg/kg/day), bronchodilators if wheezing |
| Severe (SpO2 <90%, respiratory distress, hypoxemia) | Admit to ICU, high-flow oxygen or mechanical ventilation, high-dose corticosteroids (methylprednisolone 1-2 mg/kg/day), treat secondary infection if present |