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Brush of one person with death after pulmonary insufficiency related to vaping

Within days, Alexander Mitchell passed from a 20-year-old hobbyist to being kept alive by two machines that let air in and out of his lungs and oxidize his blood outside his body.

"He went from being sick to being at the door of death literally in two days," his father Daniel Mitchell recalled as he struggled to grasp the unthinkable. "The doctor said he was dying. Honestly, I was preparing to plan my child's funeral. I cried and cried for this boy.

Alexander Mitchell's doctors at a hospital in Payson, Utah, were confused when tests returned negative for bacterial pneumonia and many common ailments. One exam, however, raised something unusual ̵

1; evidence of abnormal immune cells in his lungs – usually associated with the rare, potentially deadly pneumonia seen in older people who accidentally inhale droplets of oil-based laxatives like mineral oil.

The hit will help save Mitchell's life. The young man's lungs failed – he had a syndrome of acute respiratory distress, a life-threatening and often fatal lung injury. The doctor told the family that he suspected the condition was related to vaping after hearing about similar cases elsewhere. The man from Provo, Utah and his parents had mentioned that he used electronic cigarettes. But until then no one had connected the dots. Doctors had taken him to the University of Utah's Salt Lake City Hospital for 65 miles, so they could provide him with the most advanced life support to keep oxygen flow and allow his lungs to heal.

Mitchell's case is one of the most serious doctors have seen amongst the lung disease associated with vaping, now investigated by state and federal health officials – at least 193 cases in 22 states, many involving teenagers and young adults . On Friday, Illinois health officials announced the first known death from a vaping-related lung disease in an adult. They declined to provide further details. In the meantime, public health agencies are reporting an increasing number of cases.

There are more questions than answers about lung diseases and their relationship with devices that have increased in popularity, despite little study of their long-term effects. E-cigarettes were introduced as a way to help smokers quit by satisfying their nicotine cravings without burning themselves, but their use is already at epidemic levels among teenagers and young adults.

Those who became ill drank various substances, including nicotine-based marijuana products, and made home-cooked boils of varying lengths and places. Although the cases appear to be similar, staff at the Centers for Disease Control and Prevention are careful not to know if the diseases are related to the electronic cigarette devices themselves or to the specific ingredients or pollutants that are inhaled through them. It is not clear even if they have a common cause or whether they may be different diseases with similar symptoms.

The severity of some diseases in healthy young people who were previously healthy is impatient family members and even some doctors.

"To see patients who are sick is extremely disturbing," says Sean Callahan, a pulmonologist at the University of Utah.

Alexander Mitchell thinks he has the flu when he wakes up earlier this summer with a strong nausea, chest pain and breathing problems, but he got worse so quickly that his parents, and then even the doctors, were surprised.

Perhaps the worst moment for his parents was when the doctors said, that their son's lung deficiencies require an additional aggressive life support machine known The machine pumps blood from the patient's body to an artificial lung, which adds oxygen and removes carbon dioxide, replacing the function of their own lungs. The machine then sends the blood back to the patient.

"There were two tubes of it. one was dark red and the other was bright red, "recalls Daniel Mitchell." Doctors said one-third of his blood was out of his system at any time. "

If Alexander removed his tubes, they alerted his parents. "he will be dead in 30 seconds and so on pit what to do. . "

Doctors told the parents that he might need a lung transplant if he did not show improvement. But after about nine days, life support machines allowed his lungs to heal. He managed to get home on July 7th.

Doctors at the University of Utah who saw Mitchell, in addition to four similar cases this summer, have their own theory of what could be the cause of the vaping diseases.

They say one culprit may be the liquid, commonly known as lime juice, which is a component of all electronic cigarettes. The products vary greatly, but they all contain a heating element that produces an aerosol from a liquid that consumers inhale through a mouthpiece.

The impact in the cases may be the result of something recently added to the oils to "dilute or add to them". "Says Scott Aberg, a pulmonologist and critical care specialist at the University of Utah who looks after Mitchell and four patients at his hospital and consults with two others at another facility," he said, so if there was a previous cluster of cases, "we would have recognized it sooner."

Tracking the vaginal fluid to where it was purchased, however, is difficult in some cases. Some patients said they were buying cartridges containing ingredients in other countries. to the doctors that he has his cartridges in Las Vegas and seems to have been out rhenium is probably the introduction of THC, the main ingredient that produces mind-altering effects of marijuana, Abereg said, THC is not legal in Utah. The Food and Drug Administration, which regulates tobacco products, including e-cigarettes.

When heated, the resulting aerosol may contain fine and ultra-fine toxic particles, including heavy metals, chemicals used for flavoring, ato diacetyl, associated with a serious lung condition known as 'popcorn lung', and volatile organic compounds that can cause long-term health effects, including cancer, according to the 2016 American Surgeon General's Report

we know whether it's propylene glycol or glycerin, or other supplements in vaginal fluids put there by manufacturers, or these things in combination with other adulterers after production, when people add or mix them, "says Abereg.

Some Utah patients had milder illnesses than Mitchell's. But four out of five also have abnormal immune cells in their lungs, Aberg said. Such cells are indicators of various diseases, including a rare condition known as lipoid pneumonia, whose symptoms include chest pain and difficulty breathing – similar to the symptoms of bacterial pneumonia.

Aberg warned that he remained very unknown about what was causing the abnormal. immune cells in patients with vaping-related disease.

But "in many cases, we have a high level of confidence that what we do is not just an association, it's caused by vaping and everything in the products," said Aberg. Abnormal cells can be "a very important marker for vaping-related pneumonia" and "an important key to what is happening."

Six weeks after leaving the hospital, Mitchell resumes tourism. But with his lung capacity reduced by 25 percent, he does not walk as long or as often as before. He also struggles with his short-term memory. Doctors say they are not sure if it will fully recover.

Doctors say that his youth was a decisive factor in his survival. "He was young, otherwise healthy and in good physical condition before the onset of the disease," says Aberg, one of about 20 clinicians treating the young man.

Mitchell says he has little recollection of what happened while he was in the hospital, as he was in a medically induced coma for much of the time. But he is stunned that doctors attribute his experience to almost the death of vaping – a practice he started about two years ago because he wanted to give up conventional cigarettes.

"Promoted as healthier," he says.

Mostly he said he had used flavored nicotine products but had used THC several times with friends, he said. None of them got sick.

In mid-June, Mitchell says he bought a different brand of vape juice – peach menthol – from his regular vape shop and uses it with his same electronic cigarette device. For the first time, he uses a well-known brand. The family doesn't want to identify him until the FDA investigates further. "It was a whole new box," Mitchell recalled. Inside, "the bottle had a seal."

He said that it had fallen less than usual during that time. The next day he became ill and began his life-changing medical odyssey.

Adults can make decisions for themselves, Mitchell said. But he said his experience should be a warning of dangers not explicitly stated in connection with vaping.

"I didn't think it would cause me to be literally on my bed," he said.

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