In an early-release Oct. 11 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, the CDC presents interim guidance to help clinicians assess, evaluate, manage, and follow patients with electronic cigarette, or vaping, product use-associated lung injury (EVALI).
David A. Siegel, M.D., from the CDC in Atlanta, and colleagues assessed national surveillance data regarding clinical features of recently reported cases of EVALI. The authors then updated interim recommendations based on these data for U.S. health care providers caring for patients with suspected or known EVALI.
The interim guidance recommends that health care providers evaluating patients suspected to have EVALI ask about the use of e-cigarette, or vaping, products in “a nonjudgmental and thorough manner.” Patients suspected of having EVALI should have a chest radiograph. Hospital admission is recommended for patients with decreased blood oxygen saturation (<95 percent) on room air or who are in respiratory distress. Empiric use of a combination of antibiotics, antivirals, or steroids should be considered based on clinical context. To help patients discontinue use of e-cigarette, or vaping, products, evidence-based tobacco product cessation strategies are recommended. Patients who have been treated for EVALI should not use e-cigarette, or vaping, products to reduce the risk for recurrence.
“Rapid recognition by health care providers of patients with EVALI and an increased understanding of treatment considerations could reduce morbidity and mortality associated with this injury,” the authors write.