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• W4387248840 abstract "SESSION TITLE: That Was Toxic to Your Lungs! Exposure Associated Lung Disease SESSION TYPE: Case Reports PRESENTED ON: 10/08/2023 10:45 am - 11:45 am INTRODUCTION: Acute Respiratory Distress Syndrome (ARDS) remains a major cause of mortality among hospitalized patients, and while commonly due to pneumonia, sepsis, or aspiration of gastric contents, it can also be caused by inhalational injuries. Herein we present a case of ARDS secondary to participation in the Sleepy Chicken Challenge on social media. CASE PRESENTATION: A 61-year-old male with a history of tobacco use, COPD, chronic hepatitis C, bipolar disorder, and polysubstance use presented from a substance use rehabilitation facility with one day of progressive non-productive cough and dyspnea. In the ED, he was hypoxic with an oxygen saturation of 70% on room air, but mentating appropriately with otherwise normal vital signs. He was treated with nebulized bronchodilators, methylprednisolone and antimicrobials for presumed COPD exacerbation and community acquired pneumonia. Due to increased work-of-breathing, non-invasive positive pressure ventilation was initiated. Labs demonstrated leukocytosis without eosinophilia and a mildly elevated BNP. ABG demonstrated severe hypoxemia with PaO2/FiO2 <100. CT pulmonary angiogram demonstrated extensive bilateral airspace opacities with atelectasis and a small left-sided pleural effusion, but no pulmonary embolism. Echocardiogram demonstrated normal left ventricular function. He was ultimately intubated and developed severe ARDS. Additional history later obtained from his girlfriend revealed the patient been boiling chicken in Nyquil and inhaling the fumes for the Sleepy Chicken Challenge on social media. Infectious work-up revealed MRSA in his nares and tracheal aspirate which was also treated. His respiratory status eventually improved with standard ARDS management. He was extubated on hospital day 12 and made a full recovery. DISCUSSION: To our knowledge, this is the first reported case of ARDS secondary to Nyquil inhalation. The FDA has warned against the practice of heating Nyquil due to risks of inhalational injury. Dextromethorphan is an active ingredient in Nyquil. It is structurally similar to heroin, which when inhaled, has been associated with ARDS. This case not only highlights the dangers of substance inhalation, but also the multifactorial health impacts of social media. A recurrent public health threat is the emergence of viral video challenges, such as the Tide Pod, Benadryl and Sleepy Chicken challenges. CONCLUSIONS: Inhalational lung injury is an important consideration in the differential of ARDS. Specifically, inhalation of Nyquil or other over the counter agents can lead to significant pulmonary injury and ARDS. History taking is crucial in lung disease, especially involving inhalational exposures. It is equally prudent for providers to be aware of viral social media trends with potentially deleterious health effects. REFERENCE #1: VICKS ® NyQuil TM Severe COLD & FLU. Accessed March 15, 2023. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=6eef8a59-2f8a-1a90- REFERENCE #2: The large spectrum of pulmonary complications following illicit drug use: Features and mechanisms | Elsevier Enhanced Reader. doi:10.1016/j.cbi.2013.10.011 REFERENCE #3: Minhaj F, Leonard J. Dangers of the TikTok Benadryl challenge. 2021;38. Accessed March 15, 2023. https://www.contemporarypediatrics.com/view/dangers-of-the-tiktok-benadryl-challenge DISCLOSURES: Speaker/Speaker's Bureau relationship with Boehringer-Ingelheim Pharmaceuticals Please note: $5001 - $20000 by Jaime Betancourt, value=Honoraria Removed 03/29/2023 by Jaime Betancourt, source=Web Response Speaker/Speaker's Bureau relationship with Vapotherm, Inc Please note: $5001 - $20000 by Jaime Betancourt, value=Honoraria Removed 03/29/2023 by Jaime Betancourt, source=Web Response Speaker/Speaker's Bureau relationship with Boehringer-Ingelheim Pharmaceuticals Please note: 2014-Present by Jaime Betancourt, value=Honoraria Removed 03/29/2023 by Jaime Betancourt, source=Web Response Speaker/Speaker's Bureau relationship with Vapotherm, Inc Please note: 2019-Present by Jaime Betancourt, value=Honoraria Advisory Committee Member relationship with Vapotherm, Inc Please note: 2020 by Jaime Betancourt, value=Honoraria Removed 03/29/2023 by Jaime Betancourt, source=Web Response Speaker/Speaker's Bureau relationship with Boehringer-Ingelheim Pharmaceutical Please note: 2014-Present Added 03/29/2023 by Jaime Betancourt, source=Web Response, value=Honoraria No relevant relationships by Kevin Eng No relevant relationships by Laura Glassman No relevant relationships by Gregory Stone" @default.
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• W4387248840 date "2023-10-01" @default.
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• W4387248840 title "A UNIQUE CASE OF ACUTE RESPIRATORY DISTRESS SYNDROME FROM THE SLEEPY CHICKEN CHALLENGE: A VIRAL TREND GONE AFOWL!" @default.
• W4387248840 doi "https://doi.org/10.1016/j.chest.2023.07.2163" @default.
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