Evali is called E-cigarette associated lung injury, also known as VAPI, Vaping associated pulmonary illness.
It was initially recognised in year 2019. The exact mechanism of EVALI is still not clearly known. It a serious respiratory illness, that leads to hospital admission, requiring intensive care units and deaths.
One of the most prominent product identify to cause the lung damage is tetrahydrocannabinol and/or Vitamin E acetate. Other additives may be involved include nicotine, cannabinoid (CBD) oils, coconut oil ad limonene. These products causes inflammatory response in the air way system, which over the time lead to permanent damage to the air sacs and the airways.
Symptoms:
- Cough
- Shortness of breath
- Pleuritic chest pain
- Blood in sputum (haemoptysis)
- Some patient might experience gastrointestinal symptoms as well nausea, vomiting, diarrhea and abdominal pain.
- Fast heart breath
- Low oxygen levels.
Diagnosis:
There is no single test for making diagnosis of EVALI, it’s rather a diagnosis of exclusion from the other respirator illness which share the similar sign and symptoms. History and clinical examination along with investigation are performed to make the diagnosis. Blood tests, to assess the presence of infectious and non-infectious causes of such respiratory symptoms. CT chest plain that is high resolution CT scan and/or with contrast, CTPA to rule out other causes of low oxygen levels. Flexible bronchoscopy (a procedure to view the airways by passing a small camera through nose or mouth), to collect BAL (bronchoalveolar lavage), to exclude infectious or non-infectious cause. On some occasion lung biopsy.
Treatment
The most important step in treatment is to ensure all other possible causes have been excluded.
Depending on the severity of the symptoms patient may be treated as outpatient or hospitalised.
IV antibiotics, empirically started to cover pneumonia, systemic steroids and supportive treatment such has oxygen.
Its recommend to avoid the use of E-cigarette or vaping. For those who wish to use vaping as a bridge to quit smoking, should avoid THC or vitamin E acetate containing E-cigarette.
To quit smoking, best recommendation is take professional, physician, psychiatrist and certain groups, who can help to quit smoking
Yet more is to be learn about EVALI, but the data till now has shown hazardous impact with the use of e- cigarette. The best way to protect your lungs is to quit smoking. If you are unable to quit smoking, you should visit health care professional for guidance.