Monitoring diaphragm function in a patient with myasthenia gravis: electrical activity of the diaphragm vs. maximal inspiratory pressure

BACKGROUND: Maximal inspiratory pressure (MIP) is used to assess respiratory muscle strength of patients with myasthenia gravis (MG) requiring ventilatory support. Electrical activity of the diaphragm (E-di) has been used to guide weaning. CASE PRESENTATION: The MIP and tidal volume/ΔE-di (the patie...

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Detalles Bibliográficos
Autores principales: Koyama, Yukiko, Yoshida, Takeshi, Uchiyama, Akinori, Fujino, Yuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704593/
https://www.ncbi.nlm.nih.gov/pubmed/29209502
http://dx.doi.org/10.1186/s40560-017-0262-8
Descripción
Sumario:BACKGROUND: Maximal inspiratory pressure (MIP) is used to assess respiratory muscle strength of patients with myasthenia gravis (MG) requiring ventilatory support. Electrical activity of the diaphragm (E-di) has been used to guide weaning. CASE PRESENTATION: The MIP and tidal volume/ΔE-di (the patient-to-ventilator breath contribution) were monitored in a 12-year-old girl with MG requiring ventilator support. The same ventilatory settings were maintained until extubation. During weaning, MIP increased slightly, but varied unpredictably. Tidal volume/ΔE-di decreased at a constant rate as muscle strength recovered. CONCLUSION: In this patient with muscle weakness, E-di was a reliable tool to monitor weaning from mechanical ventilation.

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