Short-Term Outcomes From Pulmonary Rehabilitation In An Adolescent
Patient With EVALI
Abstract
Widespread usage of electronic cigarettes (e-cigarettes) has driven the
recent epidemic of e-cigarette, or vaping, product use associated lung
injury (EVALI). Recent reports have described a heterogeneous range of
pneumonitis-related sequelae from non-regulated tetrahydrocannabinol
(THC) oil extract products used through various e-cigarette devices,
piloting an ongoing federal investigation into the chemical constituents
involved in such cases. However, to the best of our knowledge, no
published reports to date have examined the impact of EVALI on
post-discharge pulmonary function tests (PFTs), and the role of
pulmonary rehabilitation in improving short-term functional outcomes. We
describe the clinical course of an adolescent male with EVALI due to the
use of an off-label THC based vaping pod. After a prolonged intubation
period in the intensive care unit he exhibited exertional dyspnea at the
outset of his rehabilitation. His initial PFTs were notable for a mixed
obstructive and restrictive lung pattern and mildly decreased diffusion
capacity. The patient had a slow and gradual improvement in his PFTs
during pulmonary rehabilitation, as well as a stepwise improvement in
his activities of daily living and resolution of substance abuse related
stressors with continued supportive counseling.