Therapy of myasthenic crisis

Abstract

None of the therapeutic regimens applied demonstrated any advantage over the others. All three regimens used were found to be effective and should be applied depending on the circumstances prevailing. Patients with myasthenic crisis must undergo careful cardiac monitoring, and temporary pace-making should be provided where clinically indicated.

The Role of Non-invasive Ventilation and Factors Predicting Extubation Outcome in Myasthenic Crisis

“…Further studies are needed to examine the associations between the sputum Definition of abbreviations: PPV = positive predict value; NPV = negative predict value; RSBI = rapid shallow breathing index; Pimax = maximal inspiratory pressure; Pemax = maximal expiratory pressure Definition of abbreviations: RSBI = rapid shallow breathing index; Pemax = maximal expiratory pressure quality, suction frequency, and extubation outcome in these patients. Ventilation failure is a common cause of mortality among MG patients [8,24,25], but few previous studies have examined the impact of extubation failure. In a study of general medical patients in a tertiary teaching hospital, Epstein et al reported that extubation failure was associated with a higher mortality, a longer ICU stay, and the requirement to transfer them to a long-term care or rehabilitation facility [18].…”

Myasthenic crisis

“…The patient usually spends half of this time intubated in the intensive care unit [8,9,13,20•,Class III]. Approximately 25% of patients are extubated on hospital day 7, 50% by hospital day 13, and 75% by hospital day 31.…”

Perioperative management in myasthenia gravis: republication of a systematic review and a proposal by the guideline committee of the Japanese Association for Chest Surgery 2014

“…Other than surgical treatment, because perioperative infections and psychological stress could be among the causes of MG crisis, they should be prevented [123][124][125]. Risk factors for the development of postoperative crisis include preoperative worsening of MG symptoms, bulbar symptoms, high blood levels of anti-AChR antibodies, a prior history of crisis, age C50 years, and vital capacity B2.0 L [122,126].…”

“…Common triggers for MG crisis include changes in medications, infections, and surgical stress [123,129]. In the perioperative period, drug changes and infections are particularly important triggers.…”