The implications of Vitamin E acetate in E-cigarette, or vaping, product use-associated lung injury.

Introduction:
This text provides an in-depth analysis of the health implications associated with the use of e-cigarettes and vaping products, specifically focusing on e-cigarette, or vaping, product use-associated lung injury (EVaLI). The reader will learn about the pathophysiology, radiological changes, histopathological findings, and clinical criteria of EVaLI, as well as the impact of Vitamin E acetate (VEa) on pulmonary toxicity. The text also discusses the differences between exogenous lipoid pneumonia and participants who inhaled VEa.

Key Points:

* EVaLI patients presented with symptoms such as dyspnea, cough, pleuritic chest pain, hemoptysis, gastrointestinal symptoms, and constitutional symptoms.
* The distinguishing factor that separates EVaLI from other types of acute lung injury is the exposure to vaping/vaping devices.
* The CDC recommended workup for EVaLI includes ruling out infectious causes and determining whether a concurrent pulmonary infection may be present.
* The pathophysiology of EVaLI is still unknown, but it may be due to a hyperactive immune response or the inhalation of base liquids in e-cigarettes.
* Radiological changes observed in EVaLI patients include ground-glass opacities, consolidation, septal thickening, subpleural sparing, and peribronchovascular sparing.
* histopathological findings in patients with EVaLI or probable diagnosis of EVaLI demonstrated patterns of acute lung injury, including acute fibrinous pneumonitis, interstitial edema, diffuse alveolar damage, or organizing pneumonia.
* VEa is a viscous lipid oil added to several vaping mixtures and can produce toxic ketene gas and carcinogen alkenes when pyrolyzed.
* Exogenous lipoid pneumonia is an uncommon condition caused by the ingestion or inhalation of mineral oils, while EVaLI is caused by the inhalation of aerosolized VEa and other oils.

Main Message:
The text emphasizes the importance of understanding the health implications associated with e-cigarette and vaping product use. EVaLI is a serious lung injury that can be caused by the inhalation of vaping products, and VEa has been identified as a major component linked to EVaLI. however, additional research is needed to determine the long-term outcomes of EVaLI and the potential health effects of other components of vaping products. Clinicians must remain up-to-date on this emerging field and continue to monitor the health effects of e-cigarette and vaping product use.

Soto B, Costanzo L, Puskoor a, akkari N, Geraghty P. The implications of Vitamin E acetate in E-cigarette, or vaping, product use-associated lung injury. annals of thoracic medicine. 2023;18(1):1-9. doi:10.4103/atm.atm_144_22