Table 1 Patients’ characteristics in the overall cohort and a compared between successful weaning after 1st extubation or not.
From: Weaning from mechanical ventilation during myasthenic crisis, a monocentric retrospective study
Overall | Successful weaning after 1st axtubation | Weaning failure after 1st extubation | p | Missing | |
|---|---|---|---|---|---|
n | 126 | 108 | 18 | ||
Age (years old) | 64 [42, 76] | 66 [47, 77] | 61 [39, 75] | 0.286 | 0.0 |
Female | 72 (56.5) | 62 (56.6) | 10 (55.6) | 1.000 | 0.0 |
Body mass Index (Kg/m2) | 25 [21, 28] | 25 [22, 28] | 21 [20, 24] | 0.132 | 36.5 |
Medical history | |||||
Pulmonary disease | 18 (14.5) | 16 (15.1) | 2 (11.1) | 0.935 | 1.6 |
Cardiac Failure | 14 (11.2) | 13 (12.1) | 1 (5.6) | 0.677 | 0.8 |
Myasthenia gravis characteristics | |||||
Delay from diagnosis to crisis (months) | 9.7 [1.3, 59.4] | 10.0 [1.6, 58.6] | 3.8 [1.0, 72.6] | 0.724 | 6.3 |
Acetylcholine Receptor Antibody | 110 (90.2) | 95 (91.3) | 15 (83.3) | 0.532 | 3.2 |
Muscle specific tyrosine kinase antibody | 8 (6.6) | 6 (5.8) | 2 (11.1) | 0.742 | 3.2 |
Thymoma present | 52 (42.6) | 47 (45.2) | 5 (27.8) | 0.262 | 3.2 |
Long course treatment in non inaugural crisis | N = 75 | N = 67 | N = 7 | ||
Thymectomy | 29 (38.7) | 27 (43.3) | 2 (28.6) | 0.449 | 0.0 |
Corticoids | 38 (51.4) | 36 (53.7) | 2 (28.6) | 0.074 | 0.8 |
Other immunosuppressive drugs | 32 (43.2) | 31 (46.3) | 1 (14.3) | 0.087 | 0.8 |
Corticoids and another IS drug | 23 (31.1) | 23 (34.3) | 0 (0) | 0.15 | |
Cholinesterase inhibitors | 71 (95.9) | 64 (95.5) | 11 (61.1) | 0.175 | 2.4 |
Precipitating factor | 94 (74.6) | 86 (79.6) | 8 (44.4) | 0.004** | 0.0 |
Infection | 51 (40.5) | 50 (46.3) | 1 (5.6) | 0.003** | 0.0 |
Pneumonia | 32 (35.6) | 31 (37.8) | 1 (12.5) | 0.298 | 28.6 |
Upper airways | 12 (12.9) | 12 (14.1) | 0 (0.0) | 0.557 | 26.2 |
Other | 11 (11.8) | 11 (12.9) | 0 (0.0) | 0.609 | 26.2 |
Iatrogenic cause | 40 (31.7) | 35 (32.4) | 5 (27.8) | 0.907 | 0.0 |
Recent Surgery | 22 (23.4) | 19 (22.1) | 3 (37.5) | 0.584 | 25.4 |
Treatment non-compliance | 8 (8.6) | 8 (9.4) | 0 (0.0) | 0.804 | 26.2 |
Corticoids introduction | 7 (7.4) | 7 (8.1) | 0 (0.0) | 0.893 | 25.4 |
Corticoids tapering | 3 (3.2) | 3 (3.5) | 0 (0.0) | 1.000 | 25.4 |
Adverse event of another drug | 6 (6.5) | 4 (4.7) | 2 (25.0) | 0.139 | 26.2 |
Other | 15 (16.0) | 13 (15.1) | 2 (25.0) | 0.822 | 25.4 |
Signs before mechanical ventilation | |||||
MV as first sign | 51 (40.8) | 40 (37.4) | 11 (61.1) | 0.102 | 0.8 |
Bulbar symptoms | 100 (82.0) | 84 (80.8) | 16 (88.9) | 0.620 | 3.2 |
Swallowing disorder | 78 (78.0) | 67 (79.8) | 11 (68.8) | 0.519 | 0.0 |
Macroscopic aspiration | 41 (42.3) | 36 (43.4) | 5 (35.7) | 0.807 | 3.0 |
Oculomotor weakness | 52 (44.1) | 42 (41.6) | 10 (58.8) | 0.289 | 6.3 |
Limb deficit | 83 (69.7) | 72 (71.3) | 11 (61.1) | 0.557 | 5.6 |
Head lift deficit | 68 (58.1) | 56 (56.6) | 12 (66.7) | 0.590 | 7.1 |
MC treatment | |||||
Feeding tube prior endotracheal intubation | 27 (24.5) | 22 (23.2) | 5 (33.3) | 0.597 | 12.7 |
Corticosteroids increase | 71 (59.7) | 57 (56.4) | 14 (77.8) | 0.150 | 5.6 |
IVIG | 76 (71.7) | 63 (70.8) | 13 (76.5) | 0.855 | 15.9 |
PE | 30 (28.6) | 22 (25.0) | 8 (47.1) | 0.121 | 16.7 |
IVIG and PE | 16 (15.7) | 11 (12.9) | 5 (29.4) | 0.180 | 19.0 |
No PE nor IVIG | 19 (17.4) | 18 (19.6) | 1 (5.9) | 0.309 | 13.5 |
NIV before intubation | 14 (14.7) | 12 (14.6) | 2 (15.4) | 1.000 | 24.6 |
General ICU severity scores | |||||
Admission SOFA | 4 [1, 5] | 4 [1, 5] | 3 [0, 5] | 0.338 | 0.8 |
SAPS II | 45 [34, 56] | 45 [34, 54] | 46 [36, 56] | 0.681 | 18.3 |
ICU adverse events | |||||
Ventilator acquired pneumonia | 32 (26.9) | 24 (23.5) | 8 (47.1) | 0.084 | 5.6 |
Septic shock | 6 (5.0) | 6 (5.8) | 0 (0.0) | 0.674 | 4.8 |
Acute respiratory distress syndrome | 5 (4.2) | 5 (4.9) | 0 (0.0) | 0.785 | 4.8 |
Other adverse events in ICU | 27 (22.3) | 23 (22.1) | 4 (23.5) | 1.000 | 4.0 |
Outcome | |||||
Weaning duration | 6 [3, 10] | 6 [4, 10] | 6 [3, 10] | 0.921 | 7.9 |
Mechanical ventilation duration | 14[10,23] | 14 [10, 23] | 17 [10, 22] | 0.683 | 5.6 |
ICU length of stay (days) | 22 [15, 35] | 20 [14, 30] | 36 [29, 50] | 0.006** | 11.9 |
Hospital length of stay (days) | 37 [27, 65] | 34 [25, 59] | 54 [40, 98] | 0.004** | 11.9 |
Mortality | 3 (2.5) | 2 (2.0) | 1 (5.6) | 0.935 | 4.8 |
