• Neurology · Nov 2002

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

    • Alejandro Rabinstein and Eelco F M Wijdicks.
    • Neurologic-Neurosurgical ICU, Saint Mary's Hospital, Mayo Medical Center, Rochester, MN 55905, USA.
    • Neurology. 2002 Nov 26; 59 (10): 1647-9.

    AbstractNoninvasive 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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