Prediction of the Need for Postoperative Mechanical Ventilation in Myasthenia Gravis

Leventhal, S. R.; Orkin, Fredrick K.; Hirsh, Robert A.

doi:10.1097/00000542-198007000-00006

Cited by 156 publications

(53 citation statements)

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“…*Males are given a numerical value (code) of I and females are given a numerical value of 2. sex) that predicted respiratory outcome in post-thymectomy patients (Table III). Surprisingly, the risk factors previously identified by Leventhal et al 3 (duration of disease, pyridostigmine dosage and history of chronic respiratory disease) were found by our analysis to be unimportant. This difference could be attributed to several reasons.…”

Section: Discussioncontrasting

confidence: 91%

“…This difference could be attributed to several reasons. First, Leventhal et al 3 were not able to include the results of the preoperative pulmonary function tests because these data were missing from the medical records of many of their patients. Although ventilatory support sustains ventilation in the presence of muscle weakness, it does not compensate for an inadequate cough.…”

Section: Discussionmentioning

confidence: 99%

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Multivariate determinants of the need for postoperative ventilation in myasthenia gravis

et al. 1996

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Multivariate determinants of the need for postoperative ventilation in myasthenia gravis

et al. 1996

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“…26 In myasthenic crisis precipitated by surgery, myasthenia lasting for Ͼ 6 y, a history of chronic respiratory disease, a dose of pyridostigmine, and a preoperative vital capacity of Ͻ 2.9 L have been singled out as predictors of the need for postoperative mechanical ventilation. 27 Our results could provide support for the proposed early use of NIV in patients with ALS. However, the lack of improvement perceived by the patient at home, such as with regard to the relief of hypoventilation-related symptoms, can interfere with NIV tolerance.…”

Section: Discussionsupporting

confidence: 69%

Predictors of Need for Noninvasive Ventilation During Respiratory Tract Infections in Medically Stable, Non-Ventilated Subjects With Amyotrophic Lateral Sclerosis

et al. 2014

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BACKGROUND: Acute lower respiratory infections can impair muscle strength in patients with amyotrophic lateral sclerosis (ALS). When associated with an increase in load on the respiratory system, this situation may precipitate hypercapnic respiratory failure in non-ventilated patients with ALS. The aim of this study was to determine whether a clinical or functional parameter can predict the need for noninvasive ventilation (NIV) during an acute respiratory infection for medically stable, non-ventilated patients with ALS. METHODS: This was a prospective study involving all non-ventilated subjects with ALS admitted due to an acute respiratory infection to a respiratory care unit from a tertiary hospital. RESULTS: Thirty-two non-ventilated subjects with ALS were admitted to our respiratory care unit due to an acute respiratory infection: 60. 72

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“…These tests may be necessary as a reference to determine the optimal conditions for extubation postoperatively as well as the need for postoperative mechanical ventilation. 3,4 The patient should be thoroughly evaluated for other associated autoimmune diseases. A chest X ray is indicated to determine the presence of aspiration or other pneumonias, which commonly occur in patients with MG. A CT scan or magnetic resonance imaging ( MRI) is indicated to detect thymoma.…”

Section: Discussionmentioning

confidence: 99%

Myasthenia gravis: Anaesthetic implications and considerations-a report of two cases

Lal

Bansal

2016

Cumhuriyet Med J

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Myasthenia gravis is an autoimmune disease characterized by weakness and fatigueability of skeletal muscles with improvement following rest. Perioperative management of such a patient poses a significant challenge to the anaesthesiologist, because it affects the neuromuscular junction. Also, the association of myasthenia gravis with other autoimmune disorders is well known. Preoperative evaluation of the patient includes review of the severity of the patient's disease and the treatment regimen. Optimisation of the condition of the myasthenic patient can markedly decrease the risk of surgery and improve the outcome. Anaesthetic management must be accomplished with the minimal applicable dose of the anaesthetic agents. Because of the unpredictable response to succinylcholine and the marked sensitivity to non depolarizing muscle relaxants, muscle relaxants should be avoided. All patients should be closely monitored postoperatively in the post anaesthesia care unit or surgical intensive care unit, where respiratory support can be immediately reinstituted.

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Prediction of the Need for Postoperative Mechanical Ventilation in Myasthenia Gravis

Cited by 156 publications

References 0 publications

Multivariate determinants of the need for postoperative ventilation in myasthenia gravis

Multivariate determinants of the need for postoperative ventilation in myasthenia gravis

Predictors of Need for Noninvasive Ventilation During Respiratory Tract Infections in Medically Stable, Non-Ventilated Subjects With Amyotrophic Lateral Sclerosis

Myasthenia gravis: Anaesthetic implications and considerations-a report of two cases

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