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What's wrong with "pneumonia" in US glass pipes? The New England Journal of Medicine disclosed in detail

by linbin on May 18, 2020
Since 2019, glass pipes has been circulating in the United States, causing pneumonia and even death among users. Recently, the authoritative international journal "New England Journal Of Medicine" published a report focusing on the highly concerned US "glass pipes" pneumonia.

  The team is mainly from the Centers for Disease Control and Prevention (CDC). As of January 7, 2020, CDC has received lung injury cases related to glass pipes or aerosolized products, including 2,558 non-fatal hospitalized patients and 60 deaths.

  The most common imaging findings of the dead patients are bilateral lesions. CT findings are 64% of lung shadow, 30% of lung infiltration, 34% of pneumonia CT, 57% of ground glass changes. All the dead patients are treated with antibiotics, 81% of intubation, 78% of glucocorticoid treatment, and 57% of ventilator treatment.
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  Since August 2019, CDC, FDA, state and local health departments, and other agencies have been investigating the nationwide outbreak of lung injury related to the use of glass pipes (or aerosolized) products (most patients with lung injury related to glass pipes or aerosolized products report the use of products containing tetrahydrocannabinoid (THC) and are hospitalized; Many people need intensive care and respiratory support. Vitamin E acetate used in glass pipes containing tetrahydrocannabinoid products is closely related to the outbreak of lung injury caused by glass pipes or aerosolized products; However, it is also difficult to rule out the effects of other chemicals.

  Cigarettes or aerosolized products enter the United States. S. market share increased rapidly in S.2007. Aerosols produced by these products usually contain nicotine, seasonings and additives, and can release other substances, such as tetrahydrocannabinol and cannabidiol, the main psychoactive ingredients in cannabis. Since products containing nicotine and tetracycline are usually different in solvents and other ingredients, dual users of nicotine and carbon tetrachloride are likely to be exposed to more ingredients.

  The United States has almost no regulations on the quality and composition of glass pipes and liquid components, including the quality and composition of solvents.
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  In a national study, researchers compared the characteristics of fatal and non-fatal lung injury cases related to glass pipes or aerosolized products to improve the ability of clinicians to identify patients who died from glass pipes or aerosolized products. As far as possible, medical records and patient interview data are included in lung injury cases related to glass pipes or aerosolized products reported by the US Department of Health to the CDC.

  Researchers analyzed all patients with lung injury related to fatal or non-fatal glass pipes or aerosolized products as of January 7, 2020. The researchers also provided reports of three patients who died of lung injury caused by glass pipes or aerosolized products to illustrate the common clinical characteristics of such patients.

  Most cases of lung injury related to glass pipes or aerosolized products are male (32 of 60 deaths, accounting for 53%); Of the 2666 non-death cases, 1666 (67%) were male.
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  The proportion of deaths aged 35 and above is relatively high (44 out of 60, accounting for 73%). Among the non-death population, the proportion of non-death population aged 35 and above is relatively low (55.1 in 2514, or 22%).

  The proportion of basic diseases in death is higher than that of non-death. For example, 23% of death cases have asthma history, while the proportion of non-death cases is 8%. 47% of the dead cases have heart disease and 10% of the dead cases are non-dead. 65% of the dead patients had a history of mental illness, and 41% of the non-dead patients had a history of mental illness. 52% of deaths are obese.

  The study found that the death toll from lung injury related to glass pipes or aerosolized products (63%) was diagnosed as acute respiratory distress syndrome, which may lead to life-threatening acute hypoxic respiratory failure. Patients with lung injury related to glass pipes or patients with aerosolized products for various chronic diseases may face higher risk of acute respiratory distress. Traditional mechanical ventilation can aggravate lung injury of patients with acute lung injury or acute respiratory distress syndrome, thus increasing the risk of non-lung organ or system failure. Therefore, clinicians should consider evidence-based principles when treating patients with acute respiratory distress syndrome.
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