J Neurocrit Care.  2024 Dec;17(2):84-87. 10.18700/jnc.240031.

Enhancing breathing through inspiratory muscle training in patients with myasthenia gravis on mechanical ventilation: a case report

• Mulyati T
• Fauzi DH
• Ganefianty A

• KMID: 2563027
• DOI: http://doi.org/10.18700/jnc.240031

Abstract

Background
Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.
Case Report
We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation.
Conclusion
This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Keyword

Inspiratory muscle training; Mechanical ventilation; Myasthenia gravis; Weaning

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