Pulmonary function tests and blood gases in worsening myasthenia gravis

Abstract

The aim of this study was to determine whether pulmonary function tests have a role in predicting the need for ventilation support in myasthenia gravis. Medical records were reviewed for 42 patients with severe myasthenia gravis who required 55 admissions to the intensive care unit. Patients with a vital capacity of more than 20 ml/kg, a maximal expiratory pressure more than 40 cm H(2)O, or a maximal inspiratory pressure more negative than -40 cm H(2)O are unlikely to require mechanical ventilation. A decline of 30% or more in maximal inspiratory pressure predicted a group at higher risk of requiring mechanical or noninvasive ventilation. Hypercapnia was frequent and was more common in patients who required mechanical ventilation. Worsening of these pulmonary function and blood gas values in patients with myasthenia gravis may guide decisions about intubation and ventilatory support.

Airway limitation and exercise intolerance in well-regulated myasthenia gravis patients

“…Most studies to date carried out pulmonary function examinations either in isolated ocular or moderately to severely affected generalized MG patients (7,8,(14)(15)(16). Most studies to date carried out pulmonary function examinations either in isolated ocular or moderately to severely affected generalized MG patients (7,8,(14)(15)(16).…”

“…Lung function testing is an objective means to verify ventilatory dysfunction (7,8). A cardiopulmonary exercise test is usually used to differentiate between cardiovascular and pulmonary causes of Objectives -Myasthenia gravis (MG) is an autoimmune disease of neuromuscular synapses, characterized by muscular weakness and reduced endurance.…”

Anti-MuSK-Positive Myasthenic Crisis in a 7-Year-Old Female

“…The unpredictable nature of these patients' respiratory status and poorly predictive values of their initial pulmonary function tests [7] make it difficult to decide between unnecessary intubation and iatrogenic harm and intubation prior to respiratory exhaustion. In adults, many studies have shown NIV to play a role in helping to prevent intubation [8–10].…”

How it feels to experience three different causes of respiratory failure

“…The clinical diagnosis of myasthenia gravis was confirmed by a strongly positive acetylcholine receptor antibody results (136×1010 M). CT chest showed a thymoma.…”

“…As ventilation decreases below 4–6 l/min, PaCO 2 rises precipitously (figure 3). 9 The degree of hypoxemia and hypercapnia varies according to the severity of the neuromuscular weakness 10…”