액상형 전자담배 용액에 의한 급성 니코틴 중독: 증례보고의 체계적 고찰
Acute Nicotine Poisoning due to Electronic Cigarette Liquid: Systematic Review of Case Reports
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.
Abstract
Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.
참고문헌 (30)
- Hua M, "Potential health effects of electronic cigarettes : A systematic review of case reports", Prev Med Rep, 4, pp.169~178 (2016)
- 이철민, "전자담배와 가열담배의 국제적 규제정책 비교", 대한의사협회지, 63(2), pp.112~118 (2020), 대한의사협회
- Tzortzi A, "A Systematic Literature Review of E-Cigarette-Related Illness and Injury : Not Just for the Respirologist", Int J Environ Res Public Health, 17, pp.E2248~ (2020)
- Hughes A, "An epidemiologic and clinical description of e-cigarette toxicity", Clin Toxicol(Phila), 57, pp.287~293 (2019)
- Mayer B, "How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century", Arch Toxicol, 88, pp.5~7 (2014)
- Lee J, "Liver Donation After Brain Death Following Intentional Ingestion of 99% E-Cigarette Liquid Nicotine 10 mL", Exp Clin Transplant, 18, pp.120~122 (2020)
- An Deok Seo, "Accidental ingestion of E-cigarette liquid nico- tine in a 15-month-old child: an infant mortality case of nicotine intoxication", Clinical and Experimental Pediatrics, 59(12), pp.490~493 (2016), 대한소아청소년과학회
- Eggleston W, "Pediatric death after unintentional exposure to liquid nicotine for an electronic cigarette", Clin Toxicol(Phila), 54, pp.890~891 (2016)
- Benowitz NL, "Clinical pharmacology of nicotine : implications for understanding, preventing, and treating tobacco addiction", Clin Pharmacol Ther, 83, pp.531~541 (2008)
- Eltorai AE, "Impact of Electronic Cigarettes on Various Organ Systems", Respir Care, 64, pp.328~336 (2019)
- Maessen GC, "Nicotine intoxication by e-cigarette liquids: a study of case reports and pathophysiology", Clin Toxicol(Phila), 58, pp.1~8 (2020)
- 박은정, "The Emerging Method of Suicide by Electronic Cigarette Liquid: a Case Report", Journal of Korean Medical Science, 33(11), pp.1~5 (2018), 대한의학회
- 김정호, "전자담배용 니코틴 원액 음독 후 발생한 심정지 1례", 대한임상독성학회지, 16(2), pp.172~175 (2018), 대한임상독성학회[DOI]
- Morley S, "Death from Ingestion of ELiquid", J Emerg Med, 53, pp.862~864 (2017)
- Rasanen M, "A Case Report of Successful Kidney Donation After Brain Death Following Nicotine Intoxication", Transplant Proc, 49, pp.229~231 (2017)
- Chen BC, "Death following intentional ingestion of e-liquid", Clin Toxicol(Phila), 53, pp.914~916 (2015)
- Thornton SL, "Fatal intravenous injection of electronic nicotine delivery system refilling solution", J Med Toxicol, 10, pp.202~204 (2014)
- De Pieri C, "Liquid Nicotine Intoxication Due to Dangerous Packaging", Pediatr Emerg Care, 36, pp.e425~ (2020)
- Belkoniene M, "Near fatal intoxication by nicotine and propylene glycol injection : a case report of an e-liquid poisoning", BMC Pharmacol Toxicol, 20, pp.28~ (2019)
- Paik JH, "Symptomatic bradycardia due to nicotine intoxication", Rev Bras Ter Intensiva, 30, pp.121~126 (2018)
- Demir E, "Sudden sensorineural hearing loss associated with electronic cigarette liquid : The first case in the literature", Int J Pediatr Otorhinolaryngol, 114, pp.26~28 (2018)
- 최지운, "전자담배 용액의 피하 주사에 의한 급성 니코틴 중독 1례", 대한임상독성학회지, 15(1), pp.60~64 (2017), 대한임상독성학회[DOI]
- Lam RPK, "Supraventricular tachycardia and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA: a case report with quantitative analysis of serum drug concentrations", Clin Toxicol(Phila), 55, pp.662~667 (2017)
- Noble MJ, "Unintentional Pediatric Ingestion of Electronic Cigarette Nicotine Refill Liquid Necessitating Intubation", Ann Emerg Med, 69, pp.94~97 (2017)
- Sommerfeld K, "Intravenous and oral suicidal e-liquid poisonings with confirmed nicotine and cotinine concentrations", Forensic Sci Int, 262, pp.e15~e20 (2016)
- Gill N, "E-Cigarette Liquid Nicotine Ingestion in a Child : Case Report and Discussion", CJEM, 17, pp.699~703 (2015)
- Schipper EM, "A new challenge : suicide attempt using nicotine fillings for electronic cigarettes", Br J Clin Pharmacol, 78, pp.1469~1471 (2014)
- Eberlein CK, "Suicide attempt by poisoning using nicotine liquid for use in electronic cigarettes", Am J Psychiatry, 171, pp.891~ (2014)
- Bassett RA, "Nicotine poisoning in an infant", N Engl J Med, 370, pp.2249~2250 (2014)
- Cervellin G, "Bad news about an old poison. A case of nicotine poisoning due to both ingestion and injection of the content of an electronic cigarette refill", Emerg Care J, 9, pp.e18~ (2013)