Myasthenia gravis and postop ventilation

Advanced, Organ-Based and Clinical Sciences

● Duration of myasthenia gravis (>6 years)

● Large doses of pyridostigmine maintenance (>750mg/day)

● Low vital capacity on PFTs (<2.9L)

More recently, additional factors have been thought to also increase chances of post-op mechanical ventilation, including (2):

● Positivity for anti-acetylcholine antibodies

● Low vital capacity (<2.9 L)

● CT scan imaging showing a thymoma

● Pre-op history of a prior myasthenic crisis

Interestingly, this study did not show any statistically significant effect of duration of myasthenia gravis or pre-op pyridostigmine dosage with regards to post-op ventilation requirements.


    Anesthesiology;1980 Jul;53(1):26-30

    [PubMed: 7386905]

    J Cardiothorac Vasc Anesth. 2018 Feb;32(1):331-333

    [PubMed: 29221974]

    See also Myasthenia gravis: postop management


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Jacob Anderson, MD