E-cigarette or vaping product use-associated acute lung injury (EVALI) as a therapeutic problem in anaesthesiology and intensive care departments

Based on the data currently available in literature, the factors inducing acute lung injury resulting from the increasingly widespread use of e-cigarettes (vaping) (EVALI) were analysed. Although the number of traditional smokers in the population has been declining, vaping may be dangerous to health due to the substances contained in various e-cigarette liquids and cause acute respiratory failure during various forms of pneumonitis. In addition to tetrahydrocannabinol (THC), cannabidiol (CB) and other opioids, the major injuring factors include standard ingredients of e-liquid, such as propylene glycol, vegetable glycerine, colouring dyes, and flavouring agents. Vaping-associated lung injury impairs the alveolar-capillary barrier and distribution of respiratory volume manifesting the features of atelectasis, which is particularly pronounced in lipoid pneumonia. Due to critical gas exchange disorders, ICU treatment is required in an increasing number of patients. The management is essentially based on steroid and antibiotic therapy; whenever the ventilator is needed, the principles of lung-protective ventilation should be strictly followed. If mechanical ventilation fails, ECMO should be considered.