Immediate physiological effects of acute electronic cigarette use in humans: A systematic review and meta-analysis - 08/12/21
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Abstract |
Background |
Electronic cigarettes (e-cigs) are widely used devices that were initially created to aid in smoking cessation. However, their acute physiological effects are unclear and there have been a number of E-cig and Vaping Acute Lung Injury (EVALI) events reported.
Research question |
What are the immediate physiological effects (i.e. cardiovascular, respiratory or blood-based responses) of acute e-cig usage in humans?
Study design and Methods |
PubMed, Web of Science, Cochrane and Scopus databases were searched for English or French peer-reviewed articles published until May 20, 2021 and measuring at least one physiological parameter before and after using an e-cig. The study followed PRISMA guidelines and assessed article quality using the Downs and Black checklist. Independent extraction was conducted by two reviewers. Data were pooled using random-effect models. Sensitivity analysis and meta-regressions were performed to explore heterogeneity.
Main outcomes |
Systolic and diastolic blood pressure, heart rate, augmentation index (AIx75), fraction of exhaled nitric oxide (FeNO), and spirometry were the most frequently assessed parameters and were therefore chosen for meta-analyses.
Results |
Of 19823 articles screened, 45 articles were included for the qualitative synthesis, and 27 articles (919 patients) were included in meta-analyses. Acute use of nicotine e-cig was associated with increased heart rate(SMD = 0.71; 95%CI 0.46–0.95), systolic blood pressure (SMD = 0.38; 95%CI 0.18–0.57), diastolic blood pressure (SMD = 0.52; 95%CI 0.33–0.70), and augmentation index AIx75 (SMD = 0.580; 95%CI 0.220–0.941), along with decreased FeNO (SMD = −0.26; 95%CI -0.49 to −0.04). E-cig exposure wasn't associated with significant changes in any spirometry measure.
Interpretation |
Acute use of nicotine e-cigs was associated with statistically significant cardiovascular and respiratory responses. These devices have a physiological impact that could be clinically relevant, especially in terms of cardiovascular morbidity. However, the direct consequences of long-term e-cig use needs to be further explored.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Meta-analysis of 27 studies assessing a wide range of physiological acute effect of e-cig and gathering 919 participants. |
• | Acute e-cig consumption led to increases in heart rate, blood pressure and arterial stiffness. |
• | FeNO decreased after acute e-cig use whereas spirometry measures did not change. |
• | Acute changes observed here have been associated with long term cardiovascular risk not yet emonstrated with e-cig usage. |
Keywords : E-cigarette, Acute effects, Physiology, Respiratory effects, Cardiovascular effects, Meta-analysis
Plan
Vol 190
Article 106684- décembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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