PT  - JOURNAL ARTICLE
AU  - Mazen Faris Odish
AU  - Amy Bellinghausen
AU  - Eugene Golts
AU  - Robert Llewellyn Owens
TI  - E-cigarette, or vaping, product use-associated lung injury (EVALI) treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO) and ultra-protective ventilator settings
AID  - 10.1136/bcr-2020-234771
DP  - 2020 Jul 01
TA  - BMJ Case Reports
PG  - e234771
VI  - 13
IP  - 7
4099  - http://casereports.bmj.com/content/13/7/e234771.short
4100  - http://casereports.bmj.com/content/13/7/e234771.full
SO  - BMJ Case Reports2020 Jul 01; 13
AB  - A 19-year-old man vaping with tetrahydrocannabinol presented with dyspnoea and right pneumothorax. History, imaging and negative infectious workup were consistent with E-cigarette, or vaping, product use-associated lung injury (EVALI). Treated with systemic steroids, he developed acute respiratory distress syndrome and was intubated requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO) by hospital day 3. Using VV-ECMO, very-low tidal volume ventilation of 1.5 cc/kg was achieved, as was daily ambulation. VV-ECMO was decannulated on hospital day 9 and the patient was extubated the next day. He was discharged home on hospital day 13 without oxygen. At post-intensive care unit clinic follow-up, he had lost 20 kg of weight while hospitalised and reported nightmares. Patients with EVALI may be supported with VV-ECMO, which allows ultra-lung-protective mechanical ventilation that may minimise ventilator-induced lung injury. Follow-up in patients with EVALI is essential to diagnose and treat comorbidities, follow lung function and prevent relapses.