Jun 22, 2021
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Smoke without fire

Doctors at the Moscow Morozov hospital managed to save a 17-year-old boy with serious lung damage. Two weeks before hospitalization, his shortness of breath and cough gradually increased, his temperature rose, moreover, in a couple of weeks he lost more than 10 kilograms. As it turned out, the young man’s hobby for vaping became the cause of health problems.

Minus ten kilograms and shortness of breath

The rescue of the teenager was reported by the press service of the capital’s health department.

– A 17-year-old boy developed severe respiratory failure, which almost led to fatal consequences. Doctors of the Morozov hospital managed to recognize the alarming symptoms in time and were among the first in Russia to diagnose a teenager with EVALI – pulmonary injury associated with electronic cigarettes and vaping products, the department said.

Two weeks before hospitalization, the young man gradually developed shortness of breath and cough, periodically increased temperature, and also had vomiting and abdominal pain. In addition, he lost a lot of weight – more than 10 kg in 2-3 weeks. As it turned out, in the last month and a half, the young man smoked vapes. As a result, he was hospitalized in the intensive care unit, where he spent more than two weeks. There he received supportive and infusion therapy, in parallel with this, a team of specialists, consisting of pulmonologists, resuscitators and employees of the Department of Pediatrics of the RUDN University, conducted a wide diagnostic search.

– According to the results of the examination and CT scan of the chest organs, signs of acute bronchiolitis – inflammation in the bronchioles (terminal branches of the bronchial tree) – were revealed. This complication is extremely rare in children over three years old and in adults. Based on the results of bronchoscopy with bronchoalveolar lavage, polymerase chain reaction, microbiological and serological studies, the infectious process was excluded. Systemic rheumatologic diseases were also excluded. Taking into account the carefully collected anamnesis, the acute development of the disease and the differential diagnosis, we were able to confirm the toxic nature of the complication and establish the diagnosis of EVALI – pulmonary injury associated with electronic cigarettes and vaping products, ” said Pavel Berezhansky, head of the pulmonology department of the Morozov Children’s Hospital, Candidate of Medical Sciences.

Thanks to the help of doctors, the young man got better: he could do without artificial oxygen supply, began to eat, talk and walk on his own. Now he has already been discharged, he continues treatment on an outpatient basis under the supervision of the pulmonologists of the Morozov hospital.

Dark matter

What exactly in the process of vaping can lead to such consequences is not yet known for sure, a pulmonologist at the RZD-Medicine Clinical Hospital named after V.I. Semashko Vyacheslav Ovechkin. According to the expert, the main risk is carried by aromatic additives, which, by the way, are still not regulated.

– The issue of vaping is not fully understood. As you know, several years ago in the United States there was a series of deaths that were associated with vaping and smoking electronic cigarettes. Then a fairly large number of people died – on the order of several dozen. Then the research continued, they caused a rather heated discussion on this topic. At that time, death was associated with additional components of the vape or flavors, the doctor said.

The name of the disease – EVALI – was given by the US Centers for Disease Control and Prevention in 2019. Its main symptoms include high body temperature, cough, vomiting, and diarrhea. Many American patients with a similar diagnosis ended up in intensive care units, as they had severe lung damage.

In most cases studied by Western experts, respiratory damage was caused by the use of non-standard vapor mixtures that contained tetrahydrocannabinol (THC) and psychoactive compounds found in marijuana. However, diagnosing the disease has proven far from easy: e-cigarettes and vaping products – unlike regular cigarettes – differ greatly from brand to brand. EVALI is closely associated with vitamin E acetate, which is added to vaping liquids as a condensing component.

The peak of EVALI diagnostics was in September 2019. By that time, the US Centers for Disease Control and Prevention had recorded more than 2.8 thousand cases and 68 deaths. Later, the number of reported cases of EVALI in the United States fell sharply – after measures were taken to regulate the market for electronic vaporizers.

However, vaping has not completely disappeared either in the West or in Russia. Scientists do not stop researching this topic. For example, as radiologists at the University of Texas have found, such devices seriously affect the lungs of even the youngest vapers and e-cigarette enthusiasts. Experts have gathered a group of 14 young people aged 13 to 18 who actively use such products. Then they underwent a complete examination using an X-ray machine and a computed tomograph.

The results were disappointing: the images showed rounded dark formations in the lower part of the lungs, and the lining of the lungs itself was deformed as if this organ had suffered a serious injury. In addition, disturbances in the functioning of the digestive system and nausea were noted.

“Imitation of harmlessness”

Often, vaping advocates are of the opinion that these devices are a more or less safe alternative to smoking. But this does not correspond to the truth, the pulmonologist Sergei Puryasev is sure.

– Vapes affect the lungs due to the fact that they dry out lung tissue, dry up the mucous membrane of the respiratory tract. Subsequently, it cracks and the penetration of infections is facilitated, which causes the tissue to suffer many times. This vapor penetrates quite deeply – up to the alveoli. The mucous membrane, alveoli are deformed and, as a result, gas exchange is disrupted, which leads to hypoxia (oxygen starvation).

According to the doctor, vaping is just an alternative to the usual cigarettes, that is, just an attempt to introduce nicotine-like substances into the human body in other ways. This is the so-called imitation of harmlessness – nothing burns, but the toxic effect is practically equivalent, Puryasev emphasizes.

Smoking vapes is no less harmful than smoking cigarettes, says Ruslan Isaev, president of the Independent Narcological Guild.

“In the production of vapes, chemicals and excipients are technologically used, which really have a detrimental effect on health – both the pulmonary system and the cardiovascular system,” he said earlier in a conversation with Izvestia.

According to him, vape liquids contain carcinogens nitrosamine and diethylene glycol, which can ultimately cause cancer.

Marta Litvinova

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