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Predictors of extubation outcomes following myasthenic crisis
OBJECTIVE: Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. METHODS: The medical charts of 33 patients (19 women, 14 men) with 76 M...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536745/ https://www.ncbi.nlm.nih.gov/pubmed/27856933 http://dx.doi.org/10.1177/0300060516669893 |
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author | Liu, Zhenguo Yao, Shiyuan Zhou, Qian Deng, Zhensheng Zou, Jianyong Feng, Huiyu Zhu, Hua Cheng, Chao |
author_facet | Liu, Zhenguo Yao, Shiyuan Zhou, Qian Deng, Zhensheng Zou, Jianyong Feng, Huiyu Zhu, Hua Cheng, Chao |
author_sort | Liu, Zhenguo |
collection | PubMed |
description | OBJECTIVE: Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. METHODS: The medical charts of 33 patients (19 women, 14 men) with 76 MC attacks from 2002 to 2014 were retrospectively reviewed. Early extubation (≤7 days) and prolonged ventilation (>15 days) during the MC were used to assess patient outcomes. RESULTS: Among the 33 patients, 24 (72.7%) had positive acetylcholine receptor antibody test results and 20 (60.6%) experienced recurrent MC attacks (≥2 episodes) during follow-up (median 83.6 months, range 1.5–177 months). Plasma exchange during an MC was significantly associated with early extubation. Male sex, older age (>50 years), atelectasis, and ventilator-associated pneumonia significantly contributed to prolonged ventilation. In 22 patients who underwent thymectomy, both the duration between MC attacks and the mean number of MC attacks were significantly reduced after surgery. CONCLUSIONS: Plasma exchange during MC attacks was found to be important for early extubation; older patients and those with atelectasis or ventilator-associated pneumonia were more vulnerable to prolonged ventilation. Thymectomy may be useful to prevent recurrence of MC. |
format | Online Article Text |
id | pubmed-5536745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-55367452017-10-03 Predictors of extubation outcomes following myasthenic crisis Liu, Zhenguo Yao, Shiyuan Zhou, Qian Deng, Zhensheng Zou, Jianyong Feng, Huiyu Zhu, Hua Cheng, Chao J Int Med Res Clinical Reports OBJECTIVE: Myasthenic crisis (MC) is considered the most severe adverse event in patients with myasthenia gravis. The present retrospective study was performed to evaluate the predictors of clinical outcomes in patients with MC. METHODS: The medical charts of 33 patients (19 women, 14 men) with 76 MC attacks from 2002 to 2014 were retrospectively reviewed. Early extubation (≤7 days) and prolonged ventilation (>15 days) during the MC were used to assess patient outcomes. RESULTS: Among the 33 patients, 24 (72.7%) had positive acetylcholine receptor antibody test results and 20 (60.6%) experienced recurrent MC attacks (≥2 episodes) during follow-up (median 83.6 months, range 1.5–177 months). Plasma exchange during an MC was significantly associated with early extubation. Male sex, older age (>50 years), atelectasis, and ventilator-associated pneumonia significantly contributed to prolonged ventilation. In 22 patients who underwent thymectomy, both the duration between MC attacks and the mean number of MC attacks were significantly reduced after surgery. CONCLUSIONS: Plasma exchange during MC attacks was found to be important for early extubation; older patients and those with atelectasis or ventilator-associated pneumonia were more vulnerable to prolonged ventilation. Thymectomy may be useful to prevent recurrence of MC. SAGE Publications 2016-11-17 2016-12 /pmc/articles/PMC5536745/ /pubmed/27856933 http://dx.doi.org/10.1177/0300060516669893 Text en © The Author(s) 2016 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Clinical Reports Liu, Zhenguo Yao, Shiyuan Zhou, Qian Deng, Zhensheng Zou, Jianyong Feng, Huiyu Zhu, Hua Cheng, Chao Predictors of extubation outcomes following myasthenic crisis |
title | Predictors of extubation outcomes following myasthenic crisis |
title_full | Predictors of extubation outcomes following myasthenic crisis |
title_fullStr | Predictors of extubation outcomes following myasthenic crisis |
title_full_unstemmed | Predictors of extubation outcomes following myasthenic crisis |
title_short | Predictors of extubation outcomes following myasthenic crisis |
title_sort | predictors of extubation outcomes following myasthenic crisis |
topic | Clinical Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536745/ https://www.ncbi.nlm.nih.gov/pubmed/27856933 http://dx.doi.org/10.1177/0300060516669893 |
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