The Macklin effect closely correlates with pneumomediastinum in acutely ill intubated patients with COVID-19 infection

Maccarrone, Valerie; Liou, Connie; D’Souza, Belinda; Salvatore, Mary M.; Leb, Jay; Belletti, Alessandro; Palumbo, Diego; Landoni, Giovanni; Capaccione, Kathleen M.

doi:10.1016/j.clinimag.2023.03.003

Cited by 7 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Evidence of linear air collection along bronchovascular sheath allowed early detection and accurate management of patients at high risk of pulmonary barotrauma. Maccarrone et al 19 also validated Macklin effect as a strong radiographic biomarker for pulmonary barotrauma. This correlation was confirmed through a case series study in which 9 out of the 10 patients who had Macklin effect developed pulmonary barotrauma.…”

Section: Discussionmentioning

confidence: 96%

Laryngotracheal trauma-induced Macklin effect: A case report

Romdhane,

Chiboub,

Amri

et al. 2024

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Laryngotracheal trauma is a relatively rare traumatic injury seen particularly in young male adults. Trauma due to strangulation is one of its most frequent circumstances. However rare, pneumomediastinum is a particular complication of severe blunt neck injuries leading to alveolar ruptures. This phenomenon, described as the Macklin effect, requires early diagnosis, and its management varies from conservative to surgical treatment depending on the severity of symptoms. Our aim is to describe the case of a 21-year-old male who presented with blunt neck trauma. Clinical and imaging findings revealed subcutaneous neck emphysema and pneumomediastinum. Treatment was conservative leading to complete resolution of the injuries and the patient was discharged after 2 weeks.

show abstract

Section: Discussionmentioning

confidence: 96%

Laryngotracheal trauma-induced Macklin effect: A case report

Romdhane,

Chiboub,

Amri

et al. 2024

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…It was intended to allow proper differentiation between respiratory and other causes of air leakage in the mediastinum that can be appreciated under CT scan and has been found to have accurately predicted the development of barotrauma with COVID-19 pneumonia. However, the result was yet to be validated in non-COVID-19 settings ( 56 , 57 ). It is essential to note that while CT scans can provide valuable information, the decision to transport critically ill patients to the CT scanner must be made cautiously and judiciously.…”

Section: Pmd and Pnxmentioning

confidence: 99%

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Teo,

Geetha,

Mishra

et al. 2024

Mediastinum

View full text Add to dashboard Cite

Background and Objective Acute respiratory distress syndrome (ARDS) is a severe, life-threatening medical condition characterized by poor oxygenation due to non-compliant lungs secondary diffuse alveolar damage. Encouragingly, the incidence of ARDS has declined steadily recently, attributed mainly to implementation of keystone guidelines and continuous research efforts. Mechanical ventilation is the cornerstone of supportive care for ARDS patients. This review aims to consolidate the current knowledge on pneumothorax (PNX) and pneumomediastinum (PMD) and to enhance the understanding of the readers. The objectives are to (I) explore the etiology and risk factors of PNX and PMD, (II) discuss the various diagnostic modalities available, (III) evaluate management options, and (IV) recent advancements. Methods A search of the literature was conducted using PubMed, MEDLINE, and Google Scholar for relevant articles pertaining to PNX and PMD in ARDS population. The clinical presentation, diagnostic and management strategies of PNX, PMD, and ARDS were summarized, and all authors reviewed the selection and decide which studies to include. Key Content and Findings The adoption of lung-protective ventilation strategies, based on the review of literature from the recent years, shows that it has played a significant role in reducing the occurrence of barotrauma, such as PNX and PMD. However, PNX and PMD remains to be a challenging complication to manage. With a specific focus on PNX and PMD, this review provides valuable insights into effectively managing and understanding these critical complications among ARDS patients. Conclusions ARDS, with its evolving definition, continues to pose a life-threatening threat. Despite the widespread adoption of lung-protective ventilation strategies, PNX and PMD present persistent challenges in management. Further research is imperative to enhance the risk assessment of ARDS patients prone to developing PNX and PMD and to institute more effective prevention and treatment measures.

show abstract

“…4 Gas contained within the pulmonary vascular sheaths can be detected in CT images and has been referred to as pulmonary interstitial emphysema (PIE) in previous human and veterinary literature. [5][6][7][8] The veterinary literature describing spontaneous pneumomediastinum due to the Macklin effect is scarce. A case series of racing Greyhounds described spontaneous pneumomediastinum identified radiographically, suspected to be a consequence of strenuous exercise.…”

Section: Introductionmentioning

confidence: 99%

“…Once the gas is within the connective tissue, it follows the path of least resistance toward the hilus of the lung and into the mediastinum 4 . Gas contained within the pulmonary vascular sheaths can be detected in CT images and has been referred to as pulmonary interstitial emphysema (PIE) in previous human and veterinary literature 5–8 …”

Section: Introductionmentioning

confidence: 99%

Pulmonary interstitial emphysema and spontaneous pneumomediastinum are more prevalent in sighthounds than other dog breeds undergoing thoracic CT

Sánchez Jiménez,

Schofield,

Plested

2024

Vet Radiology Ultrasound

View full text Add to dashboard Cite

Spontaneous pneumomediastinum is an uncommon condition described in veterinary medicine with concurrent respiratory disease. It can be caused by the Macklin effect, which is when gas leaks from the alveoli into the surrounding interstitial lung tissue. Pulmonary interstitial emphysema (PIE) is the presence of gas within the pulmonary vascular sheaths and indicates the presence of the Macklin effect. In the authors’ experience, spontaneous pneumomediastinum and PIE are more prevalent in sighthound dogs than in other breeds and are often considered incidental findings. This retrospective, observational, cross‐sectional study compared the prevalence of PIE and subsequent pneumomediastinum in sighthound with other purebred dogs. It characterized the appearance of PIE in CT and analyzed a possible association with concomitant pulmonary pathologies or with the use of general anesthesia. Medical records and thoracic CTs of sighthounds and nonsighthound dogs from two institutions were reviewed. A total of 256 dogs, comprising 127 sighthounds and 129 other purebred dogs, were included. The prevalence of PIE and pneumomediastinum was statistically higher in sighthound (14.2%) compared with other nonsighthound dogs (2.2%). There was no statistical association between the presence of PIE and pneumomediastinum with different age and weight groups or with sex. There was no statistical difference in the prevalence of PIE and pneumomediastinum between dogs with and without pulmonary pathology or in dogs undergoing CT with sedation or general anesthesia. Spontaneous pneumomediastinum in sighthounds is more prevalent than in other breeds, and its prevalence is not associated with the presence of pulmonary pathology or the use of general anesthesia.

show abstract

The Macklin effect closely correlates with pneumomediastinum in acutely ill intubated patients with COVID-19 infection

Cited by 7 publications

References 23 publications

Laryngotracheal trauma-induced Macklin effect: A case report

Laryngotracheal trauma-induced Macklin effect: A case report

Pneumomediastinum and pneumothorax in acute respiratory distress syndrome (ARDS) patients: a narrative review

Pulmonary interstitial emphysema and spontaneous pneumomediastinum are more prevalent in sighthounds than other dog breeds undergoing thoracic CT

Contact Info

Product

Resources

About