The Macklin effect closely correlates with pneumomediastinum in acutely ill intubated patients with COVID-19 infection.
Clin Imaging
; 97: 50-54, 2023 May.
Article
in English
| MEDLINE | ID: covidwho-2270150
ABSTRACT
PURPOSE:
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.METHODS:
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.RESULTS:
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%).CONCLUSION:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumothorax
/
Barotrauma
/
Lung Injury
/
COVID-19
/
Mediastinal Emphysema
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Clin Imaging
Journal subject:
Diagnostic Imaging
Year:
2023
Document Type:
Article
Affiliation country:
J.clinimag.2023.03.003
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