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10.1016/j.rmed.2022.106853

http://scihub22266oqcxt.onion/10.1016/j.rmed.2022.106853
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suck abstract from ncbi


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pmid35512457      Respir+Med 2022 ; 197 (ä): 106853
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  • Macklin effect on baseline chest CT scan accurately predicts barotrauma in COVID-19 patients #MMPMID35512457
  • Paternoster G; Belmonte G; Scarano E; Rotondo P; Palumbo D; Belletti A; Corradi F; Bertini P; Landoni G; Guarracino F
  • Respir Med 2022[Jun]; 197 (ä): 106853 PMID35512457show ga
  • PURPOSE: To validate the role of Macklin effect on chest CT imaging in predicting subsequent occurrence of pneumomediastinum/pneumothorax (PMD/PNX) in COVID-19 patients. MATERIALS AND METHODS: This is an observational, case-control study. Consecutive COVID-19 patients who underwent chest CT scan at hospital admission during the study time period (October 1st, 2020-April 31st, 2021) were identified. Macklin effect accuracy for prediction of spontaneous barotrauma was measured in terms of sensitivity, specificity, positive (PPV) and negative predictive values (NPV). RESULTS: Overall, 981 COVID-19 patients underwent chest CT scan at hospital arrival during the study time period; 698 patients had radiological signs of interstitial pneumonia and were considered for further evaluation. Among these, Macklin effect was found in 33 (4.7%), including all 32 patients who suffered from barotrauma lately during hospital stay (true positive rate: 96.9%); only 1/33 with Macklin effect did not develop barotrauma (false positive rate: 3.1%). No barotrauma event was recorded in patients without Macklin effect on baseline chest CT scan. Macklin effect yielded a sensitivity of 100% (95% CI: 89.1-100), a specificity of 99.85% (95% CI: 99.2-100), a PPV of 96.7% (95% CI: 80.8-99.5), a NPV of 100% and an accuracy of 99.8% (95% CI: 99.2-100) in predicting PMD/PNX, with a mean advance of 3.2 +/- 2.5 days. Moreover, all Macklin-positive patients developed ARDS requiring ICU admission and, in 90.1% of cases, invasive mechanical ventilation. CONCLUSIONS: Macklin effect has high accuracy in predicting PMD/PNX in COVID-19 patients; it is also an excellent predictor of disease severity.
  • |*Barotrauma/complications/diagnostic imaging[MESH]
  • |*COVID-19/complications/diagnostic imaging[MESH]
  • |*Mediastinal Emphysema/diagnostic imaging/epidemiology/etiology[MESH]
  • |*Pneumothorax/epidemiology[MESH]
  • |Case-Control Studies[MESH]
  • |Humans[MESH]


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