Cardiac disorders worsen the final outcome in myasthenic crisis undergoing non-invasive techniques

The study included 90 cases admitted to the Neurology Unit of Modena, Italy. All patients were eligible for a non-invasive ventilationtrial. The effect of cardiac comorbidities on the outcomes was analyzed, which were the need of invasive ventilation, the risk tracheostomy for weaning failure and the duration of intensive care unit (ICU) stay Females were 58.9% and males 41.1%.

Patients were classified as early or late, 34.4 and 65.6% respectively, according to age above or below 50; 85% of patients were anti- acetylcholine receptors (AChR) antibody positive. Hypertension and cardiac diseases occurred at the diagnosis in 61 and 44.4%, respectively. Invasive mechanical ventilation (MV) was needed in 34% of cases. Nine subjects (10%) underwent tracheostomy because of weaning failure. Independent predictors of non-invasive ventilationtrial failure were atrial fibrillation (AF), either parossistic or persistent, hypertensive cardiopathy and ischaemic heart disease. Hypertension (HT) had no statistical effect on the outcomes. Hypertensive cardiopathy was a predictor of weaning failure.

Researchers concluded that study shows that hypertensive cardiopathy,  atrial fibrillation and ischaemic heart disease increase the risk of non-invasive ventilation failure in myasthenic crisis receiving ventilation.