Pulmonary Functional MRI and CT in a Survivor of Bronchiolitis and Respiratory Failure Caused by e-Cigarette Use

Rachel L Eddy; Hana Serajeddini; Danielle Knipping; Simon T Landman; Karen J Bosma; Constance A Mackenzie; Inderdeep Dhaliwal; Grace Parraga

doi:10.1016/j.chest.2020.06.005

Pulmonary Functional MRI and CT in a Survivor of Bronchiolitis and Respiratory Failure Caused by e-Cigarette Use

Chest. 2020 Oct;158(4):e147-e151. doi: 10.1016/j.chest.2020.06.005. Epub 2020 Jun 13.

Authors

Rachel L Eddy¹, Hana Serajeddini², Danielle Knipping³, Simon T Landman², Karen J Bosma⁴, Constance A Mackenzie⁵, Inderdeep Dhaliwal², Grace Parraga⁶

Affiliations

¹ Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada; Department of Medical Biophysics, Department of Medicine, Western University, London, ON, Canada.
² Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada.
³ Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada.
⁴ Critical Care, Department of Medicine, Western University, London, ON, Canada.
⁵ Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada; Clinical Pharmacology and Toxicology, Department of Medicine, Western University, London, ON, Canada; Nunavut Poison Centre, Ontario, MB, Canada.
⁶ Robarts Research Institute, Department of Medicine, Western University, London, ON, Canada; Divisions of Respirology, Department of Medicine, Western University, London, ON, Canada. Electronic address: gparraga@robarts.ca.

PMID: 32544490
DOI: 10.1016/j.chest.2020.06.005

Abstract

Although nearly 3,000 e-cigarette-related hospitalizations have been reported in North America, the long-term outcomes in these patients have not been described. We followed an 18-year-old boy who survived acute critical illness and respiratory failure related to 5 months of e-cigarette use. Chronic irreversible airflow obstruction and markedly abnormal ¹²⁹Xe MRI ventilation heterogeneity was observed and persisted 8 months after hospital discharge, despite improvement in quality-of-life and chest CT findings. Lung clearance index and oscillometry measures were also highly abnormal at 8 months postdischarge. Although ¹²⁹Xe MRI ventilation abnormalities were dominant in the lung apices and central lung regions, the pattern of ventilation defects was dissimilar to ventilation heterogeneity observed in patients with obstructive lung disease, such as asthma and COPD. Our findings underscore the long-term functional impacts of e-cigarette-related lung injury in survivors of critical illness; longitudinal evaluations may shed light on the pathophysiologic mechanisms that drive e-cigarette-related lung disease.

Keywords: CT; MRI; e-Cigarettes; vaping.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Bronchiolitis / complications
Bronchiolitis / etiology*
Electronic Nicotine Delivery Systems*
Follow-Up Studies
Humans
Lung / diagnostic imaging*
Lung / physiopathology*
Magnetic Resonance Imaging*
Male
Multimodal Imaging
Respiratory Function Tests
Respiratory Insufficiency / complications
Respiratory Insufficiency / etiology*
Survivors
Tomography, X-Ray Computed*
Vaping / adverse effects*

Grants and funding

CIHR/Canada