Observational studyRespiratory medicine2022
Macklin effect on baseline chest CT scan accurately predicts barotrauma in COVID-19 patients.
Observational study in Respiratory medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05816954 (Artificial Intelligence-based Identification of Imaging Biomarkers of Lung FRAILty in Patients With Acute Respiratory Distress Syndrome.), which is not on this map. Cited by 14 papers.
What it found
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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.
Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Clinical characteristics of 40 patients with spontaneous pneumomediastinum: a retrospective study and literature review.Journal of cardiothoracic surgery · 2026Review
- Data-driven subphenotyping of severe ARDS patients requiring VV-ECMO.Frontiers in digital health · 2026Article
- 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
- Extracorporeal membrane oxygenation for prevention of barotrauma in patients with respiratory failure: A scoping review.Artificial organs · 2025Article
- Lessons Learned From Awake ECMO Approach in Covid-19-Related Acute Respiratory Distress Syndrome - a Scoping Review.Therapeutics and clinical risk management · 2025Review
- Pneumomediastinum and pneumoretroperitoneum after COVID-19: concealed intestinal perforation.BMC infectious diseases · 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
- Significant Spontaneous Pneumomediastinum and Extensive Subcutaneous Emphysema in a COVID-19 Patient.Reports (MDPI) · 2024Article
- Laryngotracheal trauma-induced Macklin effect: A case report.SAGE open medical case reports · 2024Article
- Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- Barotrauma in patients with severe coronavirus disease 2019-retrospective observational study.Journal of thoracic disease · 2023Article
- Barotrauma in COVID-19 acute respiratory distress syndrome: retrospective analysis of the COVADIS prospective multicenter observational database.BMC anesthesiology · 2023Observational
- Current and Emerging Knowledge in COVID-19.Radiology · 2023Review
- Optimizing the safety and efficacy of the awake venovenous extracorporeal membrane oxygenation in patients with COVID-19-related ARDS.Therapeutic advances in respiratory diseaseArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo 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
methodsThis 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).
resultsOverall, 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.
conclusionsMacklin effect has high accuracy in predicting PMD/PNX in COVID-19 patients; it is also an excellent predictor of disease severity.
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