Keywords
Ventilatory weaning
Postoperative respiratory complications
Anesthesia
Neuromuscular disease
Categories
How to Cite
Abstract
Myasthenia (muscle weakness) is a rare neuromuscular disease of which respiratory failure is the main complication. The accidental discovery of such disease in the perioperative period is rare and potentially serious.
We report a case of a woman who underwent an emergency operation for appendiceal peritonitis and failed repeatedly at weaning from postoperative mechanical ventilation. The usual etiologies such as postoperative respiratory complications, ventilator-associated pneumonia, acute respiratory distress syndrome complicating the septic shock or having no impact on it, and neuromyopathy’s resuscitation were considered, researched, examined, or eliminated.
Faced with the diagnostic impasse and the obvious weaning failure, another interview revealed signs of muscle fatigue which led to the diagnosis of myasthenia gravis decompensated perioperatively. Once the diagnosis was confirmed by means of a neostigmine test, the specific treatment began, particularly through plasma exchange sessions, and the process of weaning resumed. The result was complete weaning. A three-month follow-up showed a stable patient with no significant muscular disability.
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Copyright (c) 2015 Abdelilah Ghannam et al.
