Vaping and Acute Respiratory Distress Syndrome in Interventional Radiology

Vaping associated acute respiratory distress syndrome (ARDS) is a new consideration in the field of radiology with respect to tetrahydrocannabinol (THC) containing electronic nicotine delivery systems (ENDS). The appeal of ENDS product use was initially advertised as being superior to cigarettes because of the limited ingredients compared to the numerous carcinogenic elements found in cigarettes. ENDS products typically contain only four primary components including propylene glycol, vegetable glycerine, nicotine, and flavorants. In recent months, patients with a reported history of vaping have presented to the hospital with respiratory symptoms and demonstrate one of four computed tomography (CT) patterns including acute eosinophilic pneumonia, diffuse alveolar damage, organizing pneumonia, and lipoid pneumonia. The field of radiology is therefore identifying lung pathologies associated with vaping as the sole etiology, particularly in young patients. The different patterns of vaping associated lung pathology are reviewed in this article with the hope that treatment can be initiated after early image findings are identified and to guide treatment planning within the field of interventional radiology (IR).