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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
Anesthesia & Analgesia ( IF 4.6 ) Pub Date : 2021-08-16 , DOI: 10.1213/ane.0000000000005519
Deborah A. Rusy 1 , Anita Honkanen 2 , Mary F. Landrigan-Ossar 3 , Debnath Chatterjee 4 , Lawrence I. Schwartz 5 , Kirk Lalwani 6 , Jennifer R. Dollar 7 , Randall Clark 5 , Christina D. Diaz 8 , Nina Deutsch 9 , David O. Warner 10 , Sulpicio G. Soriano 3
Affiliation  

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....

中文翻译:

儿童和青少年使用电子烟和电子烟:美国麻醉医师学会小儿麻醉委员会、小儿麻醉学会和美国儿科学会麻醉学和疼痛医学分会对围手术期护理的影响

大麻等添加剂吸引了儿童和青少年。电子烟或电子烟产品使用相关肺损伤 (EVALI) 是一种新发现的与电子烟有关的肺部疾病。EVALI 的临床表现多种多样,但最常见的是呼吸系统、胃肠 (GI) 道和全身症状。EVALI 的临床管理包括停止电子烟和支持治疗,包括补充氧气、无创通气、机械通气、糖皮质激素和经验性抗生素,直到感染原因被消除,在最严重的情况下,体外膜肺氧合 (ECMO)。目前,虽然没有足够的证据来确定电子烟对围手术期戒烟的安全性和有效性,EVALI 显然将这些患者置于围手术期发病率增加的风险中。鉴于电子烟的推出相对较新,对青少年健康的长期影响尚不清楚。因此,这一潜在脆弱人群的术后结果缺乏并不支持对这些患者进行管理的循证建议。临床医生应在麻醉前评估期间识别“有风险”的个体,并相应地调整风险分层。我们的协会鼓励公众和医疗保健提供者继续教育与使用电子烟和尼古丁相关的风险,并鼓励对患者进行定期的术前筛查和术后结果研究,了解吸烟和电子烟的使用...... 鉴于电子烟的推出相对较新,对青少年健康的长期影响尚不清楚。因此,这一潜在脆弱人群的术后结果缺乏并不支持对这些患者进行管理的循证建议。临床医生应在麻醉前评估期间识别“有风险”的个体,并相应地调整风险分层。我们的协会鼓励公众和医疗保健提供者继续教育与使用电子烟和尼古丁相关的风险,并鼓励对患者进行定期的术前筛查和术后结果研究,了解吸烟和电子烟的使用...... 鉴于电子烟的推出相对较新,对青少年健康的长期影响尚不清楚。因此,这一潜在脆弱人群的术后结果缺乏并不支持对这些患者进行管理的循证建议。临床医生应在麻醉前评估期间识别“有风险”的个体,并相应地调整风险分层。我们的协会鼓励公众和医疗保健提供者继续教育与使用电子烟和尼古丁相关的风险,并鼓励对患者进行定期的术前筛查和术后结果研究,了解吸烟和电子烟的使用...... 这一潜在脆弱人群的术后结果缺乏并不支持对这些患者进行管理的循证建议。临床医生应在麻醉前评估期间识别“有风险”的个体,并相应地调整风险分层。我们的协会鼓励公众和医疗保健提供者继续教育与使用电子烟和尼古丁相关的风险,并鼓励对患者进行定期的术前筛查和术后结果研究,了解吸烟和电子烟的使用...... 这一潜在脆弱人群的术后结果缺乏并不支持对这些患者进行管理的循证建议。临床医生应在麻醉前评估期间识别“有风险”的个体,并相应地调整风险分层。我们的协会鼓励公众和医疗保健提供者继续教育与使用电子烟和尼古丁相关的风险,并鼓励对患者进行定期的术前筛查和术后结果研究,了解吸烟和电子烟的使用......
更新日期:2021-09-10
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