Korean J Anesthesiol.  1992 Aug;25(4):740-744. 10.4097/kjae.1992.25.4.740.

Prediction of the Need for Mechanical Ventilation following Thymectomy in Myasthenia Gravis

• Min KT
• Choi MY
• Kim JR

• KMID: 2033005
• DOI: http://doi.org/10.4097/kjae.1992.25.4.740

Abstract

Leventhal, et al. described a preoperative scoring system for myasthenic patients undergoing transsternal thymectomy, which includes four key risk factors. There were : 1) duration of myasthenia gravis greater than 6 years (12 points); 2) a history of chronic respiratory disease not due to myasthenia gravis(10 points); 3) a dose of pyridostigmine greater than 750mg per day 48 hours before operation (8 points); 4) a preoperative vital capacity less than 2.9L(4 points). Thirty-seven patients with myasthenia gravis undergoing transsternal thymectomy under general inhalation anesthesia with or without muscle relaxants were applied to scoring system by leventhal, et al. retrospectively. The predicitive score was assessed for each patient and the duration of postoperative mechanical ventilation was also noted for each patient. in this study, there was correct in 23/37(62.2%) of the cases, with 9 out of 27 being incorrectly predicted to be ready for tracheal extubation(false positive) and 5 out of 10 being incorrectly predicted to need ventilation(false positve). In conclusion, the scoring system proposed by leventhal, et al. may be some value in predicting whether or not a particular myasthenic patient was likely to need mechanical ventilation following transsternal thymectomy.

Keyword

Complication; myasthenia gravis; surgey; thymectomy; ventilation; mechanical

MeSH Terms

Anesthesia, Inhalation
Humans
Myasthenia Gravis*
Pyridostigmine Bromide
Respiration, Artificial*
Retrospective Studies
Risk Factors
Thymectomy*
Ventilation
Vital Capacity
Pyridostigmine Bromide