GW24-e3147 Management of Myasthenic Crisis and risk factors for prolonged mechanical ventilation. (1st October 2013)

• Record Type: Journal Article
• Authors: Ziyu, Zheng; Ying-xiong, Huang; Zi, Ye; Jia-lin, Ye; Hong, Zhan
• Is Part Of: Heart. Volume 99(2013)Supplement 3
• Page Start: A253
• Page End: A253
• Publication Date: 2013-10-01
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2013-304613.714
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: To evaluate the management of myasthenic crisis (MC) and to analyse the risk factors for prolonged mechanical ventilation. Methods: Retrospective review of consecutive patients admitted for MC between January 1994 and December 2011 in the First Affiliated Hospital of Sun Yat-sen University. Risk factors for prolonged mechanical ventilation were analysed retrospectively by age, gender, autoimmune disease, ischemic heart disease, disease duration, precipitating factor, thymoma, pneumonia, atelectasis, high-dose corticosteroid therapy and bacteremia. Results: We identified 53 episodes of MC in 38 patients. Five patients died during hospitalisation, the success rate was 90.6%. In the univariate analysis, age (P = 0.024), infectious causes (P = 0.007), concurrent atelectasis (P = 0.011), pneumonia (P = 0.027) and bacteremia (P = 0.046) were significantly related to prolonged mechanical ventilation, while age (P = 0.035), concurrent atelectasis (P = 0.042) and pneumonia (P = 0.025)were statistically significantly linked with prolonged mechanical ventilation in the multivariate analysis. Conclusions: Timely opening the airway and applying appropriate mechanical ventilation is the key to successful emergency treatment for MC; plasma exchanges or intravenous immunoglobulin can markedly improve the outcome of MC; elder, concurrent atelectasis and pneumonia are the risk factors for prolonged mechanical ventilation.