Details

Autor(en) / Beteiligte

• Maccarrone, Valerie
• Liou, Connie
• D'souza, Belinda
• Salvatore, Mary M.
• Leb, Jay
• Belletti, Alessandro
• Palumbo, Diego
• Landoni, Giovanni
• Capaccione, Kathleen M.

Titel

The Macklin effect closely correlates with pneumomediastinum in acutely ill intubated patients with COVID-19 infection

Ist Teil von

• Clinical imaging, 2023-05, Vol.97, p.50-54

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Patients with COVID-19 infection are frequently found to have pulmonary barotrauma. Recent work has identified the Macklin effect as a radiographic sign that often occurs in patients with COVID-19 and may correlate with barotrauma. We evaluated chest CT scans in COVID-19 positive mechanically ventilated patients for the Macklin effect and any type of pulmonary barotrauma. Patient charts were reviewed to identify demographic and clinical characteristics. The Macklin effect on chest CT scan was identified in a total of 10/75 (13.3%) COVID-19 positive mechanically ventilated patients; 9 developed barotrauma. Patients with the Macklin effect on chest CT scan had a 90% rate of pneumomediastinum (p < 0.001) and a trend toward a higher rate of pneumothorax (60%, p = 0.09). Pneumothorax was most frequently omolateral to the site of the Macklin effect (83.3%). The Macklin effect may be a strong radiographic biomarker for pulmonary barotrauma, most strongly correlating with pneumomediastinum. Studies in ARDS patients without COVID-19 are needed to validate this sign in a broader population. If validated in a broad population, future critical care treatment algorithms may include the Macklin sign for clinical decision making and prognostication. •We assessed the association of the Macklin Effect and pulmonary barotrauma in intubated COVID-19 patients•Pneumomediastinum occurred significantly more frequently in patients with the Macklin effect than those without•There was a trend toward more pneumothoraces in patients with the Macklin Effect; pneumothorax was frequently omolateral