Enhancing breathing through inspiratory muscle training in patients with myasthenia gravis on mechanical ventilation: a case report

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation.Conclusion: This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

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Publication Details

Journal
Journal of Neurocritical Care
Published
2024-12-26
DOI
https://doi.org/10.18700/jnc.240031
Primary Topic
Myasthenia Gravis and Thymoma
Type
article
Field-Weighted Citation Impact
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article

Enhancing breathing through inspiratory muscle training in patients with myasthenia gravis on mechanical ventilation: a case report

Amelia Ganefianty, Titin Mulyati, Deni Hamdan Fauzi
Journal of Neurocritical Care
Myasthenia Gravis and Thymoma
article

Enhancing breathing through inspiratory muscle training in patients with myasthenia gravis on mechanical ventilation: a case report

Amelia Ganefianty, Titin Mulyati, Deni Hamdan Fauzi
article en

Abstract

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation.Conclusion: This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Journal of Neurocritical CareVol. 17(2)
Dr. Hasan Sadikin General Hospital (ID)
Openalex Percentile: Top 62%
Myasthenia Gravis and Thymoma
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