Observational studyJournal of cardiothoracic and vascular anesthesia2021
Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients.
Observational study in Journal of cardiothoracic and vascular anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 56 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Artificial Intelligence-based Identification of Imaging Biomarkers of Lung FRAILty in Patients With Acute Respiratory Distress Syndrome.
Registry of Patients Undergoing Anesthesia or Intensive Care Maneuvers
Who cites it
56 citing papers in PubMed, 2 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Effects of pulmonary air leak on patients with coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis.BMC pulmonary medicine · 2023Pooled it
- Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review.Critical care medicine · 2022Pooled it
- Risk Factors for Barotrauma with Extra-Alveolar Air in a Selected COVID-19 Patient Population: Experience from a Tertiary University Hospital.Journal of clinical medicine · 2026Article
- Spontaneous Pneumomediastinum in COVID-19 and Myasthenic-like Symptom Complications in Two Relatives: A Coincidence or Spike Toxicity with Thymic Response in Predisposed Individuals? Two Clinical Cases with a Comprehensive Literature Review.Journal of clinical medicine · 2025Article
- The Predictive Power of Barotrauma from the Macklin Effect in the ARDS Population: A Comparison of COVID-19 and Non-COVID-19 ARDS-Could the Macklin Effect Serve as a Helpful Tool for Evaluating Transfer to ARDS Reference Centers?Diagnostics (Basel, Switzerland) · 2025Article
- Pneumothorax and Pneumomediastinum in SARS-CoV-2 Infection.Medicina (Kaunas, Lithuania) · 2025Article
- Extracorporeal membrane oxygenation for prevention of barotrauma in patients with respiratory failure: A scoping review.Artificial organs · 2025Article
- Unraveling Pneumomediastinum in COVID-19 Patients: Insights from a High-Volume-Center Case-Control Study.Diseases (Basel, Switzerland) · 2024Article
- Comparison of the risk of pneumothorax in COVID-19 and seasonal influenza.Scientific reports · 2024Article
- Impact of pneumothorax on mortality, morbidity, and hospital resource utilization in COVID-19 patients: a propensity matched analysis of nationwide inpatient sample database.BMC pulmonary medicine · 2024Article
- Mapping the vast landscape of multisystem complications of COVID-19: Bibliometric analysis.Heliyon · 2024Article
- Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2024Article
- Respiratory mechanics characteristics at the time of barotrauma presentation in patients with critical COVID-19 infection.Critical care science · 2024Article
- Severe SARS-CoV-2 Pneumonia and Pneumomediastinum/Pneumothorax: A Prospective Observational Study in an Intermediate Respiratory Care Unit.Journal of intensive care medicine · 2023Observational
- Barotrauma in patients with severe coronavirus disease 2019-retrospective observational study.Journal of thoracic disease · 2023Article
- Ventilator management and risk of air leak syndrome in patients with SARS-CoV-2 pneumonia: a single-center, retrospective, observational study.BMC pulmonary medicine · 2023Observational
- COVID-19: A Possible Cause of Spontaneous Pneumoperitoneum.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023Article
- The Contribution of COVID-19 to Acute Respiratory Distress Syndrome-Related Mortality in the United States.Journal of clinical medicine research · 2023Article
- Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database.BMC anesthesiology · 2023Observational
- [COVID-19-associated lung weakness (CALW): Systematic review and meta-analysis].Medicina intensiva · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the incidence, predictors, and outcome of pneumothorax (PNX)/pneumomediastinum (PMD) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS).
designObservational study.
settingTertiary-care university hospital.
participantsOne hundred sixteen consecutive critically ill, invasively ventilated patients with COVID-19 ARDS.
interventionsThe authors collected demographic, mechanical ventilation, imaging, laboratory, and outcome data. Primary outcome was the incidence of PNX/PMD. Multiple logistic regression analyses were performed to identify predictors of PNX/PMD. MEASUREMENTS AND MAIN
resultsPNX/PMD occurred in a total of 28 patients (24.1%), with 22 patients developing PNX (19.0%) and 13 developing PMD (11.2%). Mean time to development of PNX/PMD was 14 ± 11 days from intubation. The authors found no significant difference in mechanical ventilation parameters between patients who developed PNX/PMD and those who did not. Mechanical ventilation parameters were within recommended limits for protective ventilation in both groups. Ninety-five percent of patients with PNX/PMD had the Macklin effect (linear collections of air contiguous to the bronchovascular sheaths) on a baseline computed tomography scan, and tended to have a higher lung involvement at intensive care unit (ICU) admission (Radiographic Assessment of Lung Edema score 32.2 ± 13.4 v 18.7 ± 9.8 in patients without PNX/PMD, p = 0.08). Time from symptom onset to intubation and time from total bilirubin on day two after ICU admission were the only independent predictors of PNX/PMD. Mortality was 60.7% in patients who developed PNX/PMD versus 38.6% in those who did not (p = 0.04).
conclusionPNX/PMD occurs frequently in COVID-19 patients with ARDS requiring mechanical ventilation, and is associated with increased mortality. Development of PNX/PMD seems to occur despite use of protective mechanical ventilation and has a radiologic predictor sign.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.