Lung lesions caused by vaping: new challenges and new solutions (literature review)

Abstract

The modern world constantly presents us with unusual challenges. One of the new trends should include electronic cigarettes and vapes, which are firmly embedded in the ubiquitous environment of young people, including minors. In recent years, reports of cases of lung lesions associated with their use, as well as outbreaks of this new pathology, have become increasingly frequent. The article structures foreign and Russian data concerning a new pathology associated with the use of vaping. Clinical forms from exposure to electronic cigarettes can be represented by both acute lung injury (acute pneumonitis, acute respiratory distress syndrome) and a fibrous process (organizing pneumonia, respiratory bronchiolitis). The difficulties of diagnosis are caused, on the one hand, by an underestimation of the current epidemiological situation associated with vaping, on the other – by the absence of pathognomonic symptoms characteristic of EVALI. Differential diagnosis should include a wide range of diseases. Significant difficulties in verifying vape-associated lesions may occur during the rise in the incidence of influenza and COVID-19, both of which may manifest similarly or even simultaneously with EVALI. Lung damage associated with the use of vapes is essentially a diagnosis of exclusion. Therapeutic approaches are not standardized and are rather scarce. According to the literature, the basis of treatment is respiratory support, pharmacotherapy does not have a broad evidence base. In the domestic general medical practice, one should pay more attention to the collection of anamnesis, especially in young people with respiratory and gastroenterological manifestations, indicating the fact of using vapes during the survey. The focus of primary care physicians and the subsequent implementation of a publicly available diagnostic algorithm will allow for the diagnosis of EVALI in a shorter time. In the future, we will continue to study this pathology and search for more specific manifestations of it.