MYASTHENIA GRAVIS IN THE NEURO INTENSIVE CARE: EXPERIENCES

Plan and strategies in the ventilatory management changes according to the situation
anaesthetist should start keeping an eye on the patient @ the point of admission to ICU itself [if possible] and well before he/she goes into a respiratory CRISIS
meanwhile patient may respond to iv anticholineesterases / plasmapheresis and may escape a respiratory failure
Some patient may tide over the crisis with BiPAP / NIV
serial ABGs may be needed
PaO2 less than 60 and PaCO2 more than 50 is a sign board towards need for invasive ventilation

with all the above modalities of Rx, healthy recovery and discharge from the ICU is a common scene now...
SOME KEY POINTS: They are prone for atelectasis due to poor cough, low tidal volume breaths and this adds to the total work of breathing and also produces hypoxia