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Pressure support ventilation in myasthenic crisis rule of rescue

Treatment of myasthenic crisis (Mc) 11 patients are as follows. A clinical data, general information l】 cases 6 were male. 5 females. Age of l7 ~ 64 years old. 11 patients were diagnosed with MC, and have severe breathing difficulties,[link widoczny dla zalogowanych], cough, expectoration weakness; 3 cases of disturbance of consciousness; l cases of respiratory arrest. Arterial blood gas analysis were prompted to hypoxemia, 3 cases with hypercapnia. n All patients were mechanically ventilated with PSV mode, 3 down the initial use of assist / control mode ventilation (A / CMV) or combined with synchronized intermittent mandatory ventilation (SIMV). In the PSV at the same time, antibiotics,[link widoczny dla zalogowanych], immunosuppressants and other symptomatic and supportive treatment,[link widoczny dla zalogowanych], PSV 24 to 72 hours, to the anti-cholinesterase (Ache) agent. Second, PsV operating parameters inhaled gas oxygen concentration (FiO) 30 ~ 60, the pressure support level of 5 ~ 25cmHO,[link widoczny dla zalogowanych], the trigger sensitivity of a 1 to a 2cmHO, according to the patient's clinical symptoms, signs and adjust the parameters of arterial blood gas analysis,[link widoczny dla zalogowanych], while ensuring patient comfort . No breathing difficulties, respiratory rate 20cmHO, most of the tidal volume provided by the ventilator, the respiratory muscles to do work less PSV <5cmHO, most of the patients with spontaneous breathing tidal volume obtained from the initial PSV pressure to maintain the duration of remission should be based on the extent of the MC in the application of anti-AchE agents at the same time, gradually reduce the pressure support level. Each lower 2cmH0, getting a short interval of time from a long, gradual increase in the respiratory muscles to do work at the same time. Increase the tolerance of the respiratory muscles in 11 patients in this group are in the PSV pressure <8cmH: O successfully weaned from the ventilator during spontaneous breathing, there is no shortage of difficulties ventilation tube for PSV who re-set. P, SV model is the key to effective treatment means of MC, MC of the treatment can improve the success rate and shorten the treatment time with PSV features to further improve and perfect, PSV will be the most important means of respiratory support of a ventilation