Lu sur :https://www.ncbi.nlm.nih.gov/pubmed/29209502
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Monitoring diaphragm function in a patient with myasthenia gravis: electrical activity of the diaphragm vs. maximal inspiratory pressure.
Koyama Y1, Yoshida T1,2, Uchiyama A1, Fujino Y1.
J Intensive Care. 2017 Nov 28;5:66. doi: 10.1186/s40560-017-0262-8. eCollection 2017.
Abstract
- 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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