Little is known regarding the etiology DAH associated with SC

Acute pulmonary injury caused by SC inhalation is a rare event but is expected to become more common. This case demonstrates the severe life-threatening and rapid deterioration that may ensue after smoking concentrated SC through a water pipe.Immediate recognition of impending respiratory insufficiency with the subsequent need for endotracheal intubation and provision of ECMO for continued failure of adequate ventilation and gas exchange must remain an immediate priority. With the recent increase in complications of SC reported recently,one would expect there will be many more cases to come.Radiologic patterns characteristic of SC-induced pulmonary toxicity can be defined as diffuse, acute patches of alveolar infiltrates with patchy air bronchograms.

This classic radiologic presentation is a function of bronchial endothelial injury which often presents as a diffuse centrilobular nodule with tree-in-bud pattern.This response results in a pattern of injury consistent with organizing pneumonia.Histopathologic findings of organizing pneumonia are also characteristic in patients with chronic SC associated lung injury.CT radiograph may show a diffuse miliary-micronodular pattern and Chest CT may demonstrate diffuse centrilobular nodules and tree-in-bud pattern. For patients who present with unexplained pulmonary infiltrates as described above, SC use should be included on the list of differential diagnoses. An appropriate history must be taken, and drug screen testing may be indicated.In some cases,toxic metabolites have been linked to direct alveolar or bronchopulmonary injury leading to DAH . These reported metabolites have been found to vary in chemical makeup and concentrations, resulting in a range of heterogeneous effects and potency.

Testing for these cannabinoids is imperfect. ELISA is limited by the number of detectable metabolites and is not commercially available. Recently,a case of DAH associated with the SC metabolite UR-144, UR-144 N has been published . Because of the direct toxic injury,steroids have been administered and may be an effective measure. Further investigation is needed.Cannabidiol inhalation products have become increasingly available.Common routes of inhalation include water pipes and electronic delivery. Recent reports from lay press have raised concerns that vaping CBD could be more detrimental when compared to water pipe inhalation due to unknown additives such as SC in the vaping solution .ECMO has proven to be crucial in the management of nicotine vaping related pulmonary injuries . With recent CBD vaping trends in combination with an unregulated market, early anticipation and intervention with ECMO may becrucial and possibly lifesaving going forward. Agrotextiles are a kind of engineering textiles used in the agriculture, horticulture,gardening and construction. Depending on the final application, the composition,production method and properties change.Erosion Control Blanketis a kind of agrotextile. It is aimed at strengthening the soil. It is composed by a high percentage of biodegradable natural fibers. The vegetable waste pruning can be processed by Wet laid technology to obtain non-woven for different applications of ECB or composites .

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