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November 26, 2002; 59 (10) Brief Communications

BiPAP in acute respiratory failure due to myasthenic crisis may prevent intubation

Alejandro Rabinstein, Eelco F.M. Wijdicks
First published November 26, 2002, DOI: https://doi.org/10.1212/01.WNL.0000033797.79530.16
Alejandro Rabinstein
MD
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Eelco F.M. Wijdicks
MD
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Citation
BiPAP in acute respiratory failure due to myasthenic crisis may prevent intubation
Alejandro Rabinstein, Eelco F.M. Wijdicks
Neurology Nov 2002, 59 (10) 1647-1649; DOI: 10.1212/01.WNL.0000033797.79530.16

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Abstract

Noninvasive mechanical ventilation using bilevel positive pressure ventilation (BiPAP) has not been studied in acute respiratory failure caused by MG. Eleven episodes in nine patients were initially managed with BiPAP, and endotracheal intubation was avoided in seven of these trials. Presence of hypercapnia (PaCO2 greater than 50 mm Hg) at onset predicted BiPAP failure and subsequent intubation. Results of this preliminary study suggest that a trial of BiPAP may prevent intubation in patients with myasthenic crisis without overt hypercapnia.

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Letters: Rapid online correspondence

  • Reply to Letter to the Editor
    • Alejandro A. Rabinstein, Mayo Clinic Rochester MNwijde@mayo.edu
    • Eelco F. M. Wijdicks
    Submitted February 07, 2003
  • BiPAP in acute respiratory failure due to myasthenic crisis may prevent intubation
    • Claudio G. Mazia, Buenos Aires, Argentinacgmazia@intramed.net.ar
    • Eduardo L. De Vito and Marcela Varela
    Submitted February 07, 2003
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