CDC recommendations for primary care , the CDC has published updated interim guidance based on the most current data to provide a framework for healthcare providers in their management and follow-up of persons with symptoms of VAPI. Initial management involves deciding whether to admit a patient with possible VAPI to the hospital. Currently, the CDC recommends that patients with suspected VAPI should be admitted if they have decreased O saturation (<95%) on room air, are in respiratory distress, or have comorbidities that compromise pulmonary reserve. Once admitted, initiation of corticosteroids should be considered, which have been found to be helpful in treating this injury. Several case reports describe improvement with corticosteroids, likely because of a blunting of the inflammatory response. In a group of patients in Illinois and Wisconsin, 92% of 50 patients received corticosteroids, and those that began glucocorticoid therapy continued on it for at least 7 days. The medical team documented in 65% of 46 patient notes that "respiratory improvement was due to the use of glucocorticoids". Among 140 cases reported nationally to the CDC that received corticosteroids, 82% of patients improved. In patients with more severe illness, a more aggressive empiric therapy with corticosteroids as well as antimicrobial and antiviral therapy may be warranted. As a large proportion of patients were admitted to an intensive care unit based on data submitted to the CDC, many patients require supplemental oxygen via nasal cannula, high-flow oxygen, bilevel positive airway pressure (BiPAP), or mechanical ventilation. During influenza season, health care providers should consider influenza in all patients with suspected VAPI. Decisions on initiation or discontinuation of treatment should be based on specific clinical features and, when appropriate, in consultation with specialists. Special consideration should be given to high-risk patients such as the elderly, those with a history of cardiac or lung disease, or pregnant individuals. Patients over 50 years old have an increased risk of intubation and might need longer hospitalizations. CDC says patients should be advised to discontinue the use of<unk>  products upon hospital admission and during outpatient follow-up, to speed recovery and avoid potential recurrence of symptoms or lung injury. Evidence-based tobacco product quitting strategies include behavioral counseling and U.S. Food and Drug Administration (US FDA)-approved cessation medications. Follow-up care Due to reports of relapse during corticosteroid tapers after hospitalization, the CDC recommends scheduling a follow-up visit no later than one to two weeks after discharge from inpatient hospital treatment for VAPI, with considerations for performing pulse-oximetry testing and repeat CXR. In one to two months, healthcare providers should consider additional follow-up testing, including spirometry, diffusion capacity testing, and another repeat CXR. In patients with persistent hypoxemia (O saturation <95%) requiring home oxygen at discharge, consider ongoing pulmonary follow-up. In patients treated with high-dose corticosteroids, consider endocrinology follow-up to monitor adrenal function. As it is unknown whether patients with a history of VAPI are at increased risk for severe complications with influenza or other respiratory infections, follow-up care should also include annual vaccination against influenza for all persons over 6 months of age, including patients with a history of VAPI, as well as administration of the pneumococcal vaccine according to current guidelines. An important part of both inpatient and follow-up care for VAPI involves advising patients to discontinue use of e-cigarette or<unk>  products. Public health recommendations The CDC and the FDA recommend that people not use e-cigarettes or other<unk>  products that contain THC, particularly products purchased off the street or obtained from informal sources like friends, family, or online sellers. In addition, CDC recommends that individuals not modify or add any substances to e-cigarettes or other<unk>  products that are not intended by the manufacturer. Avoiding e-cigarettes entirely avoids the risk of VAPI as well as other negative health consequences of<unk> , but some health advocates promote e-cigarettes for certain populations as a means to help smokers of conventional cigarettes to quit. Research into the effectiveness of this approach is still incomplete.
Vaping-associated pulmonary injury
Ventilator-associated lung injury
Swimming-induced pulmonary edema
Occult pneumonia
Ventilator-associated pneumonia
Hospital-acquired pneumonia
Acute exacerbation of chronic obstructive pulmonary disease
Hantavirus pulmonary syndrome