Prediction of the Need for Postoperative Mechanical Ventilation in Myasthenia Gravis

Open Access
Publisher Website
Google Scholar
Abstract
To determine predictors for the postoperative need of mechanical ventilation for postoperative ventilatory inadequacy in patients with myasthenia gravis undergoing thymectomy, multivariate discriminant analysis was retrospectively applied to preoperative physical, historical and laboratory data of 24 myasthenic patients. Risk factors [4] were identified, duration of myasthenia, respiratory disease, pyridostigmine dosage and vital capacity, that allowed prediction of which patients would need postoperative mechanical ventilation and which could readily have their tracheas extubated. The 4 factors were weighted according to their respective importances in making this prediction and combined to form a preoperative scoring system. Using the resultant scores for each patient, ventilatory need in 91% of the patients was predicted only conservative errors (predicting the need for ventilatory support) were made. Traditionally used criteria for evaluating myasthenic patients were poorer predictors than these 4 factors identified by the authors. Scoring system may be clinically useful in the preoperative evaluation and postoperative care of the patient with myasthenia gravis, for it identifies important variables in the evaluation of the myasthenic patient and serves as an aid to the physician in identifying those able to tolerate early tracheal extubation.

This publication has 3 references indexed in Scilit: