Academic Journal
Macklin effect in critically COVID-19 patients: Observational single-center analysis.
| Τίτλος: | Macklin effect in critically COVID-19 patients: Observational single-center analysis. |
|---|---|
| Συγγραφείς: | Melegari G; Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria, Modena, Italy. Electronic address: melegari.gabriele@gmail.com., Arturi F; School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, Italy., Vaccari G; School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, Italy., Gazzotti F; Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria, Modena, Italy., Bertellini E; Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria, Modena, Italy., Astore L; School of Radiology, University of Modena and Reggio Emilia, Italy., Della Casa G; Department of Radiology, Azienda Ospedaliero Universitaria, Modena, Italy., Pecchi A; School of Radiology, University of Modena and Reggio Emilia, Italy., Barbieri A; School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, Italy. |
| Πηγή: | Revista espanola de anestesiologia y reanimacion [Rev Esp Anestesiol Reanim (Engl Ed)] 2025 Dec; Vol. 72 (10), pp. 501930. Date of Electronic Publication: 2025 Oct 03. |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier España Country of Publication: Spain NLM ID: 101778594 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2341-1929 (Electronic) Linking ISSN: 23411929 NLM ISO Abbreviation: Rev Esp Anestesiol Reanim (Engl Ed) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Barcelona : Elsevier España, [2015]- |
| Ιατρικοί όροι (MeSH): | COVID-19*/complications , COVID-19*/mortality , COVID-19*/therapy , COVID-19*/diagnostic imaging , Mediastinal Emphysema*/etiology , Mediastinal Emphysema*/epidemiology , Mediastinal Emphysema*/diagnostic imaging , Pneumothorax*/etiology , Pneumothorax*/epidemiology , Pneumothorax*/diagnostic imaging , Barotrauma*/etiology , Barotrauma*/epidemiology , Barotrauma*/diagnostic imaging, Subcutaneous Emphysema/etiology ; Subcutaneous Emphysema/epidemiology ; Subcutaneous Emphysema/diagnostic imaging ; Italy/epidemiology ; Humans ; Male ; Female ; Retrospective Studies ; Critical Illness ; Middle Aged ; Aged ; Tomography, X-Ray Computed ; Incidence ; Respiration, Artificial ; Adult ; Intensive Care Units |
| Περίληψη: | Objective: To analyze the incidence and impact of the Macklin effect (ME) in critically ill COVID-19 patients and its correlation with pneumothorax (PNX), spontaneous pneumomediastinum (SP), and barotraumatic complications (BC). Design: Observational single-center study. Setting: Intensive Care Unit (ICU) of a single Italian hospital. Patients or Participants: Critically ill COVID-19 patients aged ≥18 years, with at least one chest computed tomography (Ch-CT) scan and undergoing mechanical ventilation. Patients with pre-existing PNX, SP, or tracheal lesions at ICU admission were excluded. Interventions: Retrospective analysis of Ch-CT scans to detect ME. Main Variables of Interest: ME incidence, its correlation with barotrauma development and mortality. Results: Among 138 patients, ME was detected in 5.80% (8 cases) on the first Ch-CT scan and in 10.87% (15 cases) at any time during ICU stay. PNX occurred in 17.39% (24 cases) and subcutaneous emphysema in 14.49% (20 cases), with a total BC incidence of 23.91% (33 cases). ME presence on the first Ch-CT scan was significantly associated with PNX (OR 5.5, p = 0.012), SP (OR 12.77, p < 0.001), and BC (OR 11.44, p = 0.004). ME detection on the first Ch-CT scan showed a hazard ratio (HR) of 5.91 (CI 2.41-14.50, p < 0.001) for BC development. Conclusions: Early ME detection in critically ill COVID-19 patients is crucial, as it is significantly associated with PNX, SP, and BC. Recognizing ME could play a role in improving clinical management and outcomes. (Copyright © 2025 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.) |
| Competing Interests: | Declaration of competing interest Authors declare non conflict of interest. |
| Contributed Indexing: | Keywords: Barotraumatic complications; COVID-19; Complicaciones barotraumáticas; Efecto Macklin; Intensive care unit; Macklin effect; Neumomediastino espontáneo; Neumotórax; Pneumothorax; Spontaneous pneumomediastinum; Unidad de Cuidados Intensivos (UCI) |
| Entry Date(s): | Date Created: 20251005 Date Completed: 20251207 Latest Revision: 20260219 |
| Update Code: | 20260219 |
| DOI: | 10.1016/j.redare.2025.501930 |
| PMID: | 41047102 |
| Βάση Δεδομένων: | MEDLINE |
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