Doctor Rama Warning of “EVALI” disease from e-cigarettes severe pneumonia fearful of ignorant people Found easy to order online. There are many smells that are tempting to smoke.
On November 9, at Ramathibodi Hospital, Prof. Dr. Winai Wananukul, head of the Department of Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University, together with Dr. Naparat Amornputtisathaporn, Head of the Department of Respiratory Disease and Respiratory Critical Care Medicine and Dr. Thananchai Petgnak, Department of Respiratory Disease and Critical Respiratory Medicine. Department of Internal Medicine Faculty of Medicine Ramathibodi Hospital press conference “Thailand has experienced severe pneumonia (EVALI) again!! from electronic cigarettes afraid that people do not know the danger”
Prof. Dr. Winai said that people, especially teenagers, misunderstand that. E-cigarettes are safe Think of vapor as just a drop of water. There are only additives, no nicotine, which actually e-cigarette vapor has PM 2.5 dust. There are harmful chemicals that irritate the mucous membrane of the respiratory tract. Some of them are carcinogenic. There are also heavy metals from e-cigarette liquids or devices. pump The flavoring agent is heated to vapor. can cause acute pneumonia and other diseases Importantly, e-smokers are 3 times more likely to smoke regular cigarettes than people who have never smoked e-cigarettes before.
In the United States, there were 2,807 cases of severe pneumonia associated with e-cigarettes (EVALI) from 2019 to February 18, 2021, with 68 deaths. Its use is controlled, causing fewer EVALI patients. But Covid has drowned out this trend. And before, there was not much clear diagnosis. But lately we have patients with proven EVALI.
Dr. Naparat said that the company often advertises that e-cigarettes are free of harmful substances, but in fact, the main substance is nicotine, which makes it addictive. therefore does not reduce smoking but increased smoking or coupled Contains flavoring agents, cannabis compounds, increases the risk of cardiovascular disease cerebrovascular Lung disease/bronchitis and contains carcinogens that people said they haven’t found yet Because cancer is delayed, it takes decades. For EVALI, the first reported 53 cases as of July 2019, mean age 19 years, using e-cigarettes that contain 80% cannabis and 20% non-cannabis compounds, 95% symptoms include fever, chills. Cough, difficulty breathing, body aches, like a viral infection. Some people have gastrointestinal symptoms such as nausea, vomiting, and liquid diarrhea. All patients have X-ray images, CT scans, white melasma, collect lung lavage to detect white blood cells that eat fat particles. which did not find this in the infected group
“Normal breathing regular smoker will not find fat particles in the lungs and have white blood cells to eat fat will be found in the oil-spraying group that aspirated oil into the lungs which e-cigarettes contain various substances That is heated and then evaporated into fat particles such as propylene glycol, vegetabla glycerin, flavoring agents. Hemp oil substances such as vitamin E acetate, etc., but from the information, whether wearing cannabis oil or not, EVALI is also found,” said Dr. Naparat.
Dr. Naparat said that the diagnosis to identify a confirmed EVALI patient was a history of e-cigarette use 90 days before the onset of symptoms. with symptoms of shortness of breath, fever, although during that period may not be used. no infection found No heart attack, cancer, which caused similar symptoms. In addition, a WHO survey report among Thai adolescents found that e-cigarette use increased from 6-7% to 10% in 5 years, and primary school children had access to purchase. Disposable port and then claim the parents that it is not an electric cigarette because there is no charging
Dr. Thananchai said that we met a patient diagnosed with EVALI, a teenage patient aged 20-30 years, previously having congenital myositis, treated at Ramathibodi Hospital. The symptoms were well controlled and lived a normal life. Until 1 month before the treatment, I started to feel tired easily after exertion. The symptoms became more and more until 2 weeks before the examination began to cough and have more fever. more tired I have to sit and rest often. I’m tired. So I come to the emergency room to check. found very low oxygen in the blood need to provide high-flow oxygen X-ray of the lungs revealed white pneumonia. diagnosed as having severe pneumonia Admin enters the ICU Investigate the cause both collecting sputum to detect infection because during the covid period See other reasons That can cause pneumonia, such as exposure to chemicals, drugs, but the patient’s history does not tell.
“But when going back in the old history, I found that X-rays of the lungs 5 years ago revealed a characteristic abnormality in a smoker. But the patient said he never smoked. Therefore, take a new history The patient therefore agreed to say that in the past he smoked. But no longer smoked, but in the 6 months before smoking e-cigarettes as invited by a friend at work Order from group line Smoke every day, changing the flavor continuously. want to try it all Therefore, it is suspected that the patient may have EVALI problems after tracheal endoscopy. Check the lung washing water, there are white blood cells to really store fat. The biopsies are really inflamed. Therefore, there should be a real problem with EVALI,” said Dr. Thananchai.
Dr. Thananchai said Doctors give steroids to reduce inflammation. which was diagnosed early It takes about 1 day and it heals very quickly. His symptoms improved relatively quickly, he was able to go home without any other complications. back to normal which lungs will return to normal or not It depends on the severity and speed of treatment. If the inflammation has not yet formed fibrosis in the lungs Returning to work is normal. but because they are not very well known Diagnosis is slow, slow healing, pulmonary fibrosis may occur. Performance cannot return to normal. In which this case took 4 days to be treated in the hospital, he said he would not use it. and invite friends to try to cancel as well because of the crisis, fear of severe symptoms
Dr. Thananchai said that now there is a lot of use of electronic cigarettes. because it is quite easy to access Ordered online Home delivery, both working people and students are using e-cigarettes more. Guidelines for surveillance Observe the symptoms first. Respiratory symptoms may be coughing, shortness of breath, fever. Some people last for days, weeks, or months. If you have a history of using e-cigarettes have abnormal symptoms Should watch out for problems with EVALI symptoms when seeing a doctor, tell them to use e-cigarettes as well. Many people hide their history. Medical precautions If we see a patient with pneumonia, we can’t find the cause. Not likely to have an infection. EVALI should be careful to take a history of patients using e-cigarettes as well or not. As for quitting smoking, the CDC has made it clear that e-cigarettes won’t help. Medication should be used, and e-smokers may be more fearful. So don’t go back to smoking regular cigarettes. It’s best to quit both e-cigarettes and regular ones.
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