Noninvasive ventilation options in pediatric myasthenia gravis.
A 10-month-old female infant with congenital myasthenic syndrome suffering from acute respiratory failure was supported using face mask positive pressure ventilation until definitive diagnosis and specific treatment was achieved. A 12-year-old girl suffering from seronegative myasthenia gravis was treated by helmet-delivered noninvasive ventilation during recurrent myasthenic episodes. Noninvasive support was really beneficial in the myasthenic crisis with respiratory muscle weakness, whereas a shift to tracheal intubation was necessary when pulmonary infection and multiple atelectasis occurred. The new helmet interface for noninvasive positive pressure ventilation can represent a valuable means of respiratory support in the early phase of respiratory failure in older children.
Piastra
Marco
M
Pediatric Intensive Care Unit, Catholic University School of Medicine, Rome, Italy. marco.piastra@fastwebnet.it
Conti
Giorgio
G
Caresta
Elena
E
Tempera
Alessia
A
Chiaretti
Antonio
A
Polidori
Giancarlo
G
Antonelli
Massimo
M
D002648:Child; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006260:Head Protective Devices; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008171:Lung Diseases / Q000382:microbiology; D008397:Masks; D009157:Myasthenia Gravis / Q000628:therapy*; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000379:methods; D001261:Pulmonary Atelectasis / Q000628:therapy; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy; D012133:Respiratory Paralysis / Q000628:therapy