SHM Converge Scientific Abstract ePoster Gallery-From Vogue to Morgue: A Fatal Case of E-Cigarette or Vaping Use Associated Lung Injury Requiring Extra Corporeal Membrane Oxygenation

From Vogue to Morgue: A Fatal Case of E-Cigarette or Vaping Use Associated Lung Injury Requiring Extra Corporeal Membrane Oxygenation

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Pdf Summary

This case report describes a fatal episode of e-cigarette or vaping product use-associated lung injury (EVALI) in a 25-year-old woman with anxiety, depression, chronic pelvic pain from endometriosis, and daily THC vaping. She presented initially with possible seizure-like activity and was intubated in the field. After brief extubation in the emergency department, she was transferred to the ICU but required re-intubation within 24 hours because of worsening hypoxia.<br /><br />Her workup showed diffuse bilateral lung opacities on chest X-ray and CT scan, consistent with ARDS-like lung injury. Infectious testing, blood and endotracheal cultures, viral studies, and rheumatologic labs were negative. Based on her vaping history, imaging findings, and exclusion of other causes, clinicians diagnosed EVALI.<br /><br />She was treated with empiric antibiotics and prednisone, but her respiratory failure progressed. She was transferred to a higher-acuity center for ECMO. Despite maximal support, she was not a transplant candidate and later suffered a life-threatening hemorrhage requiring massive transfusion and further intubation. Her condition continued to deteriorate, and she was eventually transitioned to comfort care.<br /><br />The report highlights that EVALI is a diagnosis of exclusion and can present with respiratory, gastrointestinal, and constitutional symptoms. Proposed mechanisms include chemical pneumonitis and exogenous lipoid pneumonia. Management is primarily supportive, including oxygen, corticosteroids, mechanical ventilation, and in severe cases ECMO.<br /><br />The authors emphasize the public health importance of EVALI, especially among young people using THC-containing vape products, and note the need for improved prevention, reporting, and clinical guidance because severe cases may still result in death despite aggressive treatment.

Asset Subtitle

Fatima Elwalid

Meta Tag

Author List Fatima Elwalid, Sobia Syed, Syed R. Shah

Category Clinical Vignettes

Concept E-cigarette or Vaping-Associated Lung Injury

Concept THC-containing vaping products

Concept Diagnosis of Exclusion

Concept Hypoxemic Respiratory Failure

Concept Acute Respiratory Distress Syndrome

Distinguished Non-Finalist

Presenter Organization NW Family Medicine Residency

Presenting Author Fatima Elwalid

Track Adult

Keywords

EVALI

vaping

THC

ARDS

lung injury

respiratory failure

ECMO

corticosteroids

endometriosis

fatal case

E-cigarette or Vaping-Associated Lung Injury

THC-containing vaping products

Diagnosis of Exclusion

Hypoxemic Respiratory Failure

Acute Respiratory Distress Syndrome