CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2014; 01(02): 116-120
DOI: 10.4103/2348-0548.130388
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

What is optimal in patients with myasthenic crisis: Invasive or non-invasive ventilation?

Hemant Bhagat
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Vinod K. Grover
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Kiran Jangra
1   Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

Publication Date:
28 April 2018 (online)

Abstract

Myasthenia gravis is an immune disorder involving the neuromuscular junction. The consequent weakness of respiratory muscles leads to variable disorders of ventilation in patients with myasthenia gravis. This article reviews the options of invasive and non-invasive ventilation in patients with advanced form of the disease.

 
  • REFERENCES

  • 1 Drachman DB. Myasthenia gravis. In: Isselbacher KJ, Brauwald E, Wilson JD, Martin JB, Fauci AS. editors. Harrison's Principles of Internal Medicine. 13th ed.. New York: McGraw Hill; 1994. p. 2393-6
  • 2 Philips 2nd LH, Tomer JC, Anderson MS, Cox GM. The epidemiology of myasthenia gravis in central and western Virginia. Neurology 1992; 42: 1888-93
  • 3 Treves TA, Rocea WA, Meneghini F. Epidemiology of myasthenia gravis. In: Andreson DW, Schenberg DG. editors. Neuroepidemiology. A Tribute to Bruce Shoenberg. Boston: CRC Press; 1991. p. 297
  • 4 Ahuja GK, Mohandas S, Behari M. Myasthenia gravis: Experience with 70 patients. Neurol India 1983; 31: 15-23
  • 5 Cohen MS, Younger D. Aspects of the natural history of myasthenia crisis and death. Ann N Y Acad Sci 1981; 377: 670-7
  • 6 Gracey DR, Dievertie MB, Howard Jr. FM. Mechanical ventilation for respiratory failure in myasthenia gravis. Two-year experience with 22 patients. Mayo Clin Proc 1983; 58: 597-602
  • 7 Thomas CE, Mayer SA, Gungor Y, Swarup R, Webster EA, Chang I. et al. Myasthenia crisis: Clinical features, mortality, complications and risk factors for prolonged intubation. Neurology 1997; 48: 1253-60
  • 8 Osserman KE, Geakins G. Studies in myasthenia gravis: Reduction in mortality rate after crises. JAMA 1963; 183: 97-101
  • 9 Osserman KE. Clinical aspects. In: Osserman KE. editor. Myasthenis gravis. New York: Grune and Stratton; 1958. p. 79-80
  • 10 Ropper AH, Shahani BT. Diagnosis and management of acute are flexic paralysis with special emphasis on Guillane-Barre syndrome. In: Ashbury AK, Gilliat RW. editors. Peripheral Nerve Disorders. London: Butterworth; 1984. p. 21-45
  • 11 Treatment of critically ill patients with myasthenia gravis. In: Ropper AH, Gress DR, Diringer MN, Green DM, Mayer SA, Bleck TP. editors. Neurological and Neurosurgical Intensive Care. 4th ed.. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 299-311
  • 12 Nomori H, Ishihara T. Pressure controlled ventilation via a mini-tracheostomy tube for patients with neuromuscular disease. Neurology 2000; 55: 698-702
  • 13 Mehta S, Hill NS. Noninvasive ventilation. Am J Respir Crit Care Med 2001; 163: 540-77
  • 14 Sharma D, Bithal PK, Dash HH. Respiratory care of myasthenic crisis in neuro-intensive care unit: Evaluation of outcome and adverse events. DM (Neuroanaesthesiology) Research Project. 2006. AIIMS; New Delhi: 2006
  • 15 Varelas PN, Chua HC, Natterman J, Barmadia L, Zimmerman P, Yahia A. et al. Ventilatory care in myasthenia gravis crisis: Assessing the baseline adverse event rate. Crit Care Med 2002; 30: 2663-8
  • 16 Murthy JM, Meena AK, Chowdary GV, Narayanan JT. Myasthenia crises: Clinical features, complications and mortality. Neurol India 2005; 53: 37-40
  • 17 Piastra M, Conti G, Caresta E, Tempera A, Chiaretti A, Polidori G. et al. Non-invasive ventilation options in pediatric myasthenia gravis. Pediatr Anesth 2005; 15: 699-702
  • 18 Seneviratne J, Mandrekar J, Wijdicks EF, Rabinstein AA. Non-invasive ventilation in myasthenic crisis. Arch Neurol 2008; 65: 54-8
  • 19 Rabinstein A, Wijdicks EF. BiPAP in acute respiratory failure due to myasthenic crisis may prevent intubation. Neurology 2002; 59: 1647-9
  • 20 Wu JY, Kuo PH, Fan PC, Wu HD, Shih FY, Yang PC. The role of non-invasive ventilation and factors predicting extubation outcome in myasthenic crisis. Neurocrit Care 2009; 10: 35-42
  • 21 Agarwal R, Reddy C, Gupta D. Non-invasive ventilation in acute neuromuscular respiratory failure due to myasthenic crisis: Case report and review of literature. Emerg Med J 2006; 23: e6