Early Tracheostomy Is Associated With Shorter Ventilation Time and Duration of ICU Stay in Patients With Myasthenic Crisis—A Multicenter Analysis

Angstwurm, Klemens ; Vidal, Amelie ; Stetefeld, Henning ; Dohmen, Christian ; Mergenthaler, Philipp ; Kohler, Siegfried ; Schönenberger, Silvia ; Bösel, Julian ; Neumann, Ursula ; Lee, De-Hyung ; Gerner, Stefan T. ; Huttner, Hagen B. ; Thieme, Andrea ; Dunkel, Juliane ; Roth, Christian ; Schneider, Hauke ; Schimmel, Eik ; Reichmann, Heinz ; Fuhrer, Hannah ; Berger, Benjamin ; Kleiter, Ingo ; Schneider-Gold, Christiane ; Alberty, Anke ; Zinke, Jan ; Schalke, Berthold ; Steinbrecher, Andreas ; Meisel, Andreas ; Neumann, Bernhard

In: Journal of Intensive Care Medicine, 37 (2022), Nr. 1. pp. 32-40. ISSN 0885-0666 (Druck-Ausg.), 1525-1489 (Online-Ausg.)

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Official URL: https://doi.org/10.1177/0885066620967646

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DOI: 10.11588/heidok.00031158
URN: urn:nbn:de:bsz:16-heidok-311581
URL: http://www.ub.uni-heidelberg.de/archiv/31158

Abstract

Background: Myasthenic crisis (MC) requiring mechanical ventilation (MV) is a rare and serious complication of myasthenia gravis. Here we analyzed the frequency of performed tracheostomies, risk factors correlating with a tracheostomy, as well as the impact of an early tracheostomy on ventilation time and ICU length of stay (LOS) in MC. Methods: Retrospective chart review on patients treated for MC in 12 German neurological departments between 2006 and 2015 to assess demographic/diagnostic data, rates and timing of tracheostomy and outcome. Results: In 107 out of 215 MC (49.8%), a tracheostomy was performed.Patients without tracheostomy were more likely to have an early-onset myasthenia gravis (27 [25.2%] vs 12 [11.5%], p ¼ 0.01).Patients receiving a tracheostomy, however, were more frequently suffering from multiple comorbidities (20 [18.7%] vs 9 [8.3%].

Document type:	Article
Journal or Publication Title:	Journal of Intensive Care Medicine
Volume:	37
Number:	1
Publisher:	Sage
Place of Publication:	Thousand Oaks, Calif.
Edition:	Zweitveröffentlichung
Date Deposited:	20 Jan 2022 13:05
Date:	2022
ISSN:	0885-0666 (Druck-Ausg.), 1525-1489 (Online-Ausg.)
Page Range:	pp. 32-40
Faculties / Institutes:	Medizinische Fakultät Heidelberg > Neurologische Universitätsklinik
DDC-classification:	610 Medical sciences Medicine
Uncontrolled Keywords:	myasthetic crisis, mechanical ventilation, tracheostomy
Additional Information:	Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. *** This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.