Noninvasive ventilation options in pediatric myasthenia gravis

• Published in: Pediatric anesthesia Vol. 15; no. 8; pp. 699 - 702
• Main Authors: PIASTRA, MARCO, CONTI, GIORGIO, CARESTA, ELENA, TEMPERA, ALESSIA, CHIARETTI, ANTONIO, POLIDORI, GIANCARLO, ANTONELLI, MASSIMO
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.08.2005; Blackwell
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Equipment Design; Female; Follow-Up Studies; Head Protective Devices; Humans; Infant; Intubation, Intratracheal; Lung Diseases - microbiology; Masks; Medical sciences; myasthenia gravis; Myasthenia Gravis - therapy; noninvasive; Positive-Pressure Respiration - instrumentation; Positive-Pressure Respiration - methods; Pulmonary Atelectasis - therapy; Respiration, Artificial - instrumentation; Respiration, Artificial - methods; Respiratory Insufficiency - therapy; Respiratory Paralysis - therapy; ventilation; Human; Pediatrics; Neuromuscular diseases; Nervous system diseases; Myasthenia gravis; noninvasive; ventilation; Anesthesia; Child
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1111/j.1460-9592.2005.01617.x

Summary A 10‐month‐old female infant with congenital myasthenic syndrome suffering from acute respiratory failure was supported using facemask positive pressure ventilation until definitive diagnosis and specific treatment was achieved. A 12‐year‐old girl suffering from seronegative myasthenia gravis was treated by helmet‐delivered noninvasive ventilation during recurrent myasthenic episodes. Noninvasive support was really beneficial in the myasthenic crisis with respiratory muscle weakness, whereas a shift to tracheal intubation was necessary when pulmonary infection and multiple atelectasis occurred. The new helmet interface for noninvasive positive pressure ventilation can represent a valuable means of respiratory support in the early phase of respiratory failure in older children.