Authors: Nadya Farhana, Zulkifli Amin
Background: Myasthenia gravis is characterized by muscle weakness and fatigability. The affected muscle are ocular muscle, oropharyngeal muscle, facial muscle, and respiratory muscle. This leads to respiratory failure in myasthenia gravis patients with myasthenic crisis. Noninvasive ventilation has been used to treat patients with hypercapnia respiratory failure and associated with reduction of the need of endotracheal intubation, reduction of complication rate, reduction of hospital stays, and reduction of mortality. In myasthenia gravis patients with respiratory failure, there is no evidence that noninvasive ventilation would reduce those factors. Thus, we studied the effectiveness of noninvasive ventilation in myasthenia gravis patients with respiratory failure in reducing the need of endotracheal intubation and increase extubation outcomes.
Methods: Literature review on PubMed, Elton B. Stephens Co. (EBSCO), Cochrane, and ScienceDirect yield two relevant articles.
Results: Two studies showed that noninvasive ventilation in subject with myasthenia gravis with respiratory failure had better effect.
Conclusion: It is effective to use noninvasive ventilation in subject with myasthenia gravis during their respiratory failure in myasthenic crisis.