11-14-2019 What Chemical was Identified in Bronchoalveolar Lavage (BAL) Specimens of Patients Suffering from Vaping Associated Lung Injury (EVALI)?

Toxicology Question of the Week

11/14/2019

What Chemical was Identified in Bronchoalveolar Lavage (BAL) Specimens of Patients Suffering from Vaping Associated Lung Injury (EVALI)?

Vitamin E acetate was detected in all 29 patient BAL samples. Among 23 patients for whom self-reported THC use information was available, 20 reported using THC-containing products. THC or its metabolites were detected in 23 of 28 patient BAL samples, including in those of three patients who said they did not use THC products.

Nicotine metabolites were detected in 16 of 26 patient BAL specimens. Results for plant oils, MCT oil, petroleum distillates, and diluent terpenes were all below analyte-specific levels of detection (typically in the low ng/mL range).” (Blount BC et al Evaluation of Bronchoalveolar Lavage Fluid from Patients in an Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injury — 10 States, August–October 2019, MMWR Morb Mortal Wkly Rep. epub: 8 November 2019. DOI: https://www.cdc.gov/mmwr/volumes/68/wr/mm6845e2.htm)

Click here to view related attachments: Updated Guidance and TDH Vaping Questionnaire

This question was prepared by: Donna Seger, MD

We have had requests for more information about vaping.  I’m sure you heard of the recent double lung transplant that was performed following vaping injury.  There is still so much we don’t know, but we will keep you informed. -ds

I am interested in any questions you would like answered in the Question of the Week.  Please email me with any suggestion at donna.seger@vumc.org.

Donna Seger, MD

Executive Director

Tennessee Poison Center

www.tnpoisoncenter.org

Poison Help Hotline: 1-800-222-1222