• Christine Gaik, Christian Arndt, Nadine Mand, Monika Bauck, Nicolaus Schwerk, Christina Westhoff, Iris Bittmann, and Hinnerk Wulf.
• From the Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Campus Marburg, Philipps-University Marburg, Germany (CG, CA, HW), Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics, Philipps-University, Marburg, Germany (NM), Paediatric Pulmonology, Department of Pediatrics, Philipps-University, Marburg, Germany (MB), Clinic for Paediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Centre for Lung Research, Hannover, Germany (NS), Institute of Pathology, Philipps-University Marburg and University Hospital Marburg (UKGM), Universitaetsklinikum Marburg, Marburg, Germany (CW), Institute of Pathology, Agaplesion Diakonieklinikum Rotenburg Wümme gGmbH, Germany (IB).
• Eur J Anaesthesiol. 2024 Jul 1; 41 (7): 530534530-534.

AbstractSince 2019 when a cluster of cases with acute respiratory distress syndrome (ARDS) associated with e-cigarettes in the United States was reported, there have been increasing numbers of reports. Electronic-cigarette or Vaping Use-associated Lung Injury (EVALI) represents a recent entity of respiratory clinical syndromes, primarily in young adults. We report a previously healthy 16-year-old boy who developed severe ARDS following a brief nonspecific prodromal phase after excessive consumption of e-cigarettes. Despite maximum intensive care therapy, including several weeks of venovenous extracorporeal membrane oxygenation, plasmapheresis and repeated administration of immunoglobulins seemed the only way to achieve therapeutic success. Although many case reports have been published, to our knowledge, there are none to date on the therapeutic use of plasmaphoresis in severe EVALI. This case highlights the clinical features of EVALI and the diagnostic dilemma that can arise with EVALI occurring against the background of an expired SARS-CoV-2 infection, with a paediatric inflammatory syndrome (PIMS) as differential diagnosis. EVALI is a diagnosis of exclusion, and the medical history of vaping and e-cigarette use can provide valuable clues. Ethical approval for this case report (protocol number 23-145 RS) was provided by the Ethical Committee of the Department of Medicine, Philipps-Universität Marburg, Germany on 13 th of June 2023. Written informed consent to publish this case and the associated images was obtained from the patient and his mother.Copyright © 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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