Nav: Home

Physicians create guide for identifying, treating vaping lung illness

November 08, 2019

As lung injuries from vaping continue to rise across the United States, Rochester physicians and New York health leaders developed a new tool to assist in the diagnosis and treatment of e-cigarette, or vaping, product use associated lung injury (EVALI).

The diagnostic/treatment algorithm, published in The Lancet Respiratory Medicine, complements and expands upon early guidance from the Centers for Disease Control and Prevention for managing the condition. It was created by pulmonary and toxicology experts at the University of Rochester and the New York State Department of Health.

"This illness has been vexing for physicians across the country and we continue to see people suffering from the dangerous effects of vaping," said Daniel Croft, M.D., M.P.H., pulmonologist at the University of Rochester Medical Center's Strong Memorial Hospital. "We expect the guide will help minimize missed diagnoses as cold and flu season ramps up."

"As the Department of Health continues our investigation into this ongoing outbreak of vaping-associated illnesses, we are in close contact with health care providers across the state and are pleased to provide them with a new tool to help with proper diagnoses," said Health Commissioner Howard Zucker, M.D., J.D. "We continue to urge New Yorkers to stop using vape products until the investigation is complete."

The nationwide epidemic began in the spring and to date, the CDC has charted more than 2,000 cases, including 40 deaths. The cause of the illness remains a mystery, though many patients used products containing THC, the psychoactive component in marijuana. Patients experience devastating lung injury, some requiring long hospitalizations and treatment in the intensive care unit, followed by a slow recovery.

"This is a practical and user-friendly algorithm for clinicians when they are evaluating EVALI. It provides a flow-chart for information-gathering, evaluation and treatment of patients who are experiencing this life-threatening condition," said Aleksandr Kalininskiy, M.D., a lead author with Christina Bach, M.D., at URMC.

Rochester physicians were first in the state to report unusual symptoms to the NYSDOH, and those early discussions led to an extensive and collaborative effort to track symptoms and identify appropriate testing, treatment and follow-up care. Data and samples of vaping materials from URMC's nearly 20 patients were shared with NYSDOH, and its poison control centers, for analysis.

The first cases identified at Strong Memorial date back to June, said Nicholas Nacca, M.D., medical toxicologist and emergency physician, when a colleague asked him to review a young man's "weird symptoms." Nacca discussed it with other toxicologists in a professional organization's online forum, where similar cases were shared, providing an early indication of the epidemic to come.
-end-
URMC is home to the Center for Inhalation and Flavoring Toxicology Research, one of the nation's leading laboratories for study of the health effects of flavorings found in electronic cigarettes, tobacco and non-tobacco products. Scientists have analyzed vaping samples as part of the investigation into the source of the illness.

Additional authors of the article are Matthew McGraw, M.D., of URMC, Gary Ginsberg, Ph.D., and Kristen Navarette, M.D., of the NYSDOH; and Jeanna Marraffa, Pharm.D., of the Upstate New York Poison Control Center at SUNY Upstate Medical University.

University of Rochester Medical Center

Related Health Articles:

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.
Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.
Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.
Geographic and health system correlates of interprofessional oral health practice
In the current issue of Family Medicine and Community Health (Volume 6, Number 2, 2018, pp.
Bloomberg era's emphasis on 'health in all policies' improved New Yorkers' heart health
From 2002 to 2013, New York City implemented a series of policies prioritizing the public's health in areas beyond traditional healthcare policies and illustrated the potential to reduce cardiovascular disease risk.
Youth consider mobile health units a safe place for sexual health services
Mobile health units bring important medical services to communities across the country.
Toddler formulas and milks -- not recommended by health experts -- mislead with health claims
Misleading labeling on formulas and milks marketed as 'toddler drinks' may confuse parents about their healthfulness or necessity, finds a new study by researchers at the NYU College of Global Public Health and the Rudd Center for Food Policy & Obesity at the University of Connecticut.
Women's health has worsened while men's health has improved, trends since 1990 show
Swedish researchers have studied health trends among women and men aged 25-34 from 1990-2014.
Health insurance changes, access to care by patients' mental health status
A research letter published by JAMA Psychiatry examined access to care before the Patient Protection and Affordable Care Act (ACA) and after the ACA for patients grouped by mental health status using a scale to assess mental illness in epidemiologic studies.
Community health workers lead to better health, lower costs for Medicaid patients
As politicians struggle to solve the nation's healthcare problems, a new study finds a way to improve health and lower costs among Medicaid and uninsured patients.
More Health News and Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.