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Research ArticleConference Proceedings

Neuromuscular Disease Causing Acute Respiratory Failure

Sangeeta Mehta
Respiratory Care September 2006, 51 (9) 1016-1023;
Sangeeta Mehta
Interdepartmental Division of Critical Care Medicine, and the Division of Respirology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
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Abstract

In the developed world, Guillain-Barré syndrome and myasthenia gravis account for the majority of cases of acute respiratory failure associated with neuromuscular disease. The 4 components that contribute to respiratory failure are upper-airway dysfunction, inspiratory-muscle weakness, expiratory-muscle weakness, and the pulmonary complications associated with these conditions. Careful observation and objective monitoring are essential to determine the appropriate timing of intubation and mechanical ventilation. Pulmonary function tests that can help predict the need for mechanical ventilation include vital capacity, peak inspiratory pressure, and peak expiratory pressure. The morbidity and mortality of patients who require mechanical ventilation are not insubstantial. This paper will review the mechanisms underlying acute respiratory failure, the clinical assessment of patients, the predictors of the need for mechanical ventilation, and the intensivecare-unit morbidity and mortality of patients with Guillain-Barré syndrome or myasthenia gravis.

  • neuromuscular disease
  • acute respiratory failure
  • myasthenia gravis
  • Guillain-Barré syndrome
  • endotracheal intubation
  • vital capacity
  • maximum inspiratory pressure
  • maximum expiratory pressure
  • complications
  • noninvasive positive-pressure ventilation

Footnotes

  • Correspondence: Sangeeta Mehta MD FRCPC, Medical/Surgical Intensive Care Unit, Mount Sinai Hospital, 600 University Avenue, #18-216, Toronto, Ontario, M5G 1X5, Canada. E-mail: geeta.mehta{at}utoronto.ca.
  • Sangeeta Mehta MD FRCPC presented a version of this paper at the 37th RESPIRATORY CARE Journal Conference, “Neuromuscular Disease in Respiratory and Critical Care Medicine,” held March 17-19, 2006, in Ixtapa, Mexico.

  • Copyright © 2006 by Daedalus Enterprises Inc.
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Respiratory Care: 51 (9)
Respiratory Care
Vol. 51, Issue 9
1 Sep 2006
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Neuromuscular Disease Causing Acute Respiratory Failure
Sangeeta Mehta
Respiratory Care Sep 2006, 51 (9) 1016-1023;

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Neuromuscular Disease Causing Acute Respiratory Failure
Sangeeta Mehta
Respiratory Care Sep 2006, 51 (9) 1016-1023;
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Keywords

  • neuromuscular disease
  • acute respiratory failure
  • myasthenia gravis
  • Guillain-Barré syndrome
  • endotracheal intubation
  • vital capacity
  • maximum inspiratory pressure
  • maximum expiratory pressure
  • complications
  • noninvasive positive-pressure ventilation

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Print ISSN: 0020-1324        Online ISSN: 1943-3654

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