Faculty Collaboration Database

Vaping and E-Cigarette Use in Children and Adolescents: Implications on Perioperative Care From the American Society of Anesthesiologists Committee on Pediatric Anesthesia, Society for Pediatric Anesthesia, and American Academy of Pediatrics Section on Anesthesiology and Pain Medicine. Anesth Analg 2021 Sep 01;133(3):562-568

Date

03/30/2021

Pubmed ID

33780391

DOI

10.1213/ANE.0000000000005519

Scopus ID

2-s2.0-85113171919 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Electronic cigarettes (e-cigarettes) or vaping use in adolescents has emerged as a public health crisis that impacts the perioperative care of this vulnerable population. E-cigarettes have become the most commonly used tobacco products among youth in the United States. Fruit and mint flavors and additives such as marijuana have enticed children and adolescents. E-cigarette, or vaping, product use-associated lung injury (EVALI) is a newly identified lung disease linked to vaping. Clinical presentation of EVALI can be varied, but most commonly includes the respiratory system, gastrointestinal (GI) tract, and constitutional symptoms. Clinical management of EVALI has consisted of vaping cessation and supportive therapy, including supplemental oxygen, noninvasive ventilation, mechanical ventilation, glucocorticoids, and empiric antibiotics, until infectious causes are eliminated, and in the most severe cases, extracorporeal membrane oxygenation (ECMO). Currently, although there is an insufficient evidence to determine the safety and the efficacy of e-cigarettes for perioperative smoking cessation, EVALI clearly places these patients at an increased risk of perioperative morbidity. Given the relatively recent introduction of e-cigarettes, the long-term impact on adolescent health is unknown. As a result, the paucity of postoperative outcomes in this potentially vulnerable population does not support evidence-based recommendations for the management of these patients. Clinicians should identify "at-risk" individuals during preanesthetic evaluations and adjust the risk stratification accordingly. Our societies encourage continued education of the public and health care providers of the risks associated with vaping and nicotine use and encourage regular preoperative screening and postoperative outcome studies of patients with regard to smoking and vaping use.

Author List

Rusy DA, Honkanen A, Landrigan-Ossar MF, Chatterjee D, Schwartz LI, Lalwani K, Dollar JR, Clark R, Diaz CD, Deutsch N, Warner DO, Soriano SG

Author

Christina D. Diaz MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age Factors
Child
Clinical Decision-Making
Electronic Nicotine Delivery Systems
Female
Humans
Inhalation Exposure
Lung Diseases
Male
Nicotine
Nicotinic Agonists
Perioperative Care
Postoperative Complications
Risk Assessment
Risk Factors
Smokers
Vaping