University of Massachusetts Medical School Faculty Publications

UMMS Affiliation

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine

Publication Date


Document Type



Critical Care | Pulmonology | Respiratory Tract Diseases


Exposure to vaping is associated with a growing list of respiratory syndromes including an acute progressive form with life-threatening hypoxemic respiratory failure and pathologic changes of lung injury termed vaping-associated respiratory distress syndrome.

Data Sources: Center from Disease Control, Departments of Public Health, MEDLINE (via PubMed), and the Cochrane Library.

Study Selection Data Extraction and Data Synthesis: Cases, series, and public health reports of cases that met the Centers for Disease Control and Prevention case definition of vaping-associated respiratory disease were extracted by an author with perfect verification by a second. Cases were classified on the basis of toxin exposure, symptoms, oxygen saturation, progression to respiratory failure, and pathologic features, and a clinically actionable system of classification was based on expert opinion.

Conclusions: The reported spectrum of vaping-associated respiratory diseases allows clinical classification of cases into groups with distinct evaluation, management, and recommendations for prevention and follow-up. Clinical stratification also identifies a small proportion of vaping-exposed patients who are at risk for progression to hypoxemic respiratory failure and an acute respiratory distress syndrome-like illness.


acute respiratory distress syndrome, e-cigarette, respiratory failure, review, vape, vaping

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Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

DOI of Published Version



Lilly CM, Khan S, Waksmundzki-Silva K, Irwin RS. Vaping-Associated Respiratory Distress Syndrome: Case Classification and Clinical Guidance. Crit Care Explor. 2020 Feb 24;2(2):e0081. doi: 10.1097/CCE.0000000000000081. PMID: 32211613; PMCID: PMC7069591. Link to article on publisher's website

Related Resources

Link to article in PubMed

Journal/Book/Conference Title

Critical Care Explorations

PubMed ID


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.