[Pubmed] Management of Mechanical Ventilation and Weaning in Critically Ill Patients with Neuromuscular Disorders

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Respir Med. 2025 Jan 16:107951. doi: 10.1016/j.rmed.2025.107951. Online ahead of print.

ABSTRACT

PURPOSE: Myasthenia-gravis and Guillain-Barre-syndrome are two of the most common causes of acute and reversible neuromuscular-respiratory-failure(ARNRF), both may worsen respiratory-failure and need for invasive-mechanical-ventilation(IMV) for long-periods due to muscle-weakness. However, approitive IMV-mode for ARNRF patients that better gas-exchange and weaning in ARNRF remain unclear.

MATERIALS AND METHODS: Critically-ill-patiens with IMV due to ARNRF, who could meet the weaning-criterias (after intubation for more than 7-days; difficult-weaning), between 2013, and 2023 were included in the study. IMV-settings, simultaneous arterial-blood-gas (ABG) analyses, and prognosis were recorded for each patient on relevant days.

RESULTS: Sixty-critically-ill-patients with ARNRF who defined as difficult-weaning were included in the study. When different IMV-modes were used in the same patient, simultaneous ABG results were compared for each ventilation-mode. It was determined that the partial-pressure-of-oxygen/fraction of inspired-oxygen-ratios were significantly higher and partial-carbon-dioxide-levels were significantly lower when critically-ill-patients were ventilated with the biphasic-positive-airway-pressure-ventilation(BIPAP) (95% CI: [0.641-1.41]; p

Source: https://pubmed.ncbi.nlm.nih.gov/3982676 ... t9+e462414