Disclosures: Mazen Zein, DO: No financial relationships or conflicts of interest

Case Description: As vaping becomes a much greater mainstream form of nicotine use and the legalization of marijuana increases, there will be a need to better understand the effects it has on the body. The patient suffered from acute respiratory failure secondary to vaping induced lung injury requiring venous-venous extracorporeal membrane oxygenation (VV ECMO) followed by bilateral lung transplant. The patient was followed and evaluated by a team of physicians, therapists and nursing staff for functional outcome and adverse events related to their IPR stay. Functional Independence Measure (FIM) instrument scores were gathered upon admission and at discharge from IPR. The main independent variables included activities of daily living, transfers, ambulation/wheelchair, and stairs.

Setting: Inpatient acute care rehabilitation center

Patient: A 17-year-old Caucasian male status-post bilateral lung transplant Assessment/

Results: Comparison of admission to discharge FIM scores demonstrated improvement in mobility from moderate assistance to complete independence. Ambulation progressed from none to 90 feet with rolling walker and supervision. Wheelchair mobility improved from not attempted to 150 feet. Both activities of daily living and transfers improved from moderate/maximum assistance to complete independence. His rehabilitation course was complicated by several adverse events including symptomatic tachycardia, hypertension, thoracic musculoskeletal pain and episodes of nausea/vomiting. Patient also experienced anxiety and psychiatric adjustment disorder to his medical condition. Patient was able to be stabilized and continue IPR during his stay.

Discussion: To date, this is the first reported case of a patient admitted to inpatient rehabilitation (IPR) following a bilateral lung transplant secondary to vaping induced lung injury and monitored for functional outcome and adverse events.

Conclusion: The patient demonstrated significant functional improvement in multiple FIM scores. As vaping use becomes more prevalent its detrimental effects will continue to reveal themselves. Physiatrists must be aware of new social habits and understand the harm they may cause.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/inpatient-rehabilitation-outcome-following-bilateral-lung-transplant-secondary-to-vaping-induced-lung-injury-a-case-report/