title: "Smoking wet": respiratory failure related to smoking tainted marijuana cigarettes.
abstract: Reports have suggested that the use of a dangerously tainted form of marijuana, referred to in the vernacular as "wet" or "fry," has increased. Marijuana cigarettes are dipped into or laced with other substances, typically formaldehyde, phencyclidine, or both. Inhaling smoke from these cigarettes can cause lung injuries. We report the cases of 2 young adults who presented at our hospital with respiratory failure soon after they had smoked "wet" marijuana cigarettes. In both patients, progressive hypoxemic respiratory failure necessitated rescue therapy with extracorporeal membrane oxygenation. After lengthy hospitalizations, both patients recovered with only mild pulmonary function abnormalities. To our knowledge, this is the first 2-patient report of severe respiratory failure and rescue therapy with extracorporeal oxygenation after the smoking of marijuana cigarettes thus tainted. We believe that, in young adults with an unexplained presentation of severe respiratory failure, the possibility of exposure to tainted marijuana cigarettes should be considered.
authors: Departments of Pulmonary and Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA. cgilbert1@hmc.psu.edu
authors: Christopher R
authors: CR
authors: Gilbert
authors: Michael
authors: M
authors: Baram
authors: Nicholas C
authors: NC
authors: Cavarocchi
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005557:Formaldehyde / Q000009:adverse effects*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D008385:Marijuana Smoking / Q000009:adverse effects*; D010623:Phencyclidine Abuse / Q000150:complications*; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015208:Smoke Inhalation Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005557:Formaldehyde
keywords: Formaldehyde/ adverse effects/toxicity; lung diseases/chemically induced; marijuana smoking/adverse effects/complications/epidemiology; phencyclidine abuse; respiration, artificial/methods; respiratory distress syndrome, adult/etiology/therapy; respiratory insufficiency/chemically induced; street drugs/adverse effects; substance abuse detection; substance-related disorders/complications/diagnosis/prevention & control