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. 2024 Feb 28;69(3):333-338.
doi: 10.4187/respcare.11308.

Home Noninvasive Ventilation in Myasthenia Gravis

Jesús Sancho  1 , Santos Ferrer  2 , Antonio Quezada  2 , Elia Gimenez  2 , Jaime Signes-Costa  2
Affiliations

Home Noninvasive Ventilation in Myasthenia Gravis

Jesús Sancho et al. Respir Care. .

Abstract

Background: Noninvasive ventilation (NIV) plays an important role in avoiding endotracheal intubation during myasthenic crisis, yet there are few published data concerning long-term home NIV in stable out-patients with myasthenia gravis (MG). The aim of this study was to describe the prevalence of NIV in a cohort of subjects with stable MG and to analyze contributing factors that could predict the need of NIV.

Methods: We performed a cross-sectional study that included subjects diagnosed with MG managed in the respiratory care unit over the previous year. Subjects underwent clinical analysis including demographic, clinical, and functional respiratory data.

Results: Of the 50 subjects included, 35 (70%) were positive for nicotinic acetylcholine receptor antibodies, and 68% had a diagnosis of generalized MG. Bulbar symptoms developed in 16 (32%), and 10 (20%) subjects needed long-term home NIV. The only variable predicting the need for long-term NIV was MG severity measured with Myasthenia Gravis Foundation of America (MGFA), mainly grades IIB (odds ratio 0.14 [95% CI 0.02-0.85], P = .03) and IIIB (odds ratio 0.02 [95% CI 0.01-0.34], P = .01).

Conclusions: Home NIV was needed in a substantial percentage of medically stable subjects with MG, mainly in those with generalized type and with oropharyngeal and/or respiratory muscle involvement (MGFA grades IIB and IIIB).

Keywords: myasthenia gravis; noninvasive ventilation; respiratory failure.

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Conflict of interest statement

The authors have disclosed no conflicts of interest.

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