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NEUROLOGY 1984;34:336
© 1984 American Academy of Neurology

Myasthenia gravis

Determinants for independent ventilation after transsternal thymectomy

D. S. Younger, MD, N.M.T. Braun, MD, A. Jaretzki, III, MD, A. S. Penn, MD and R. E. Lovelace, MD

From the Departments of Medicine (Drs. Younger and Braun), Surgery (Dr. Jaretzki), and Neurology (Drs. Penn and Lovelace), Columbia-Presbyterian Medical Center and the H. Houston Merritt Center for Muscular Dystrophy and Related Diseases.

We evaluated the respiratory function of 32 patients with myasthenia gravis who had transsternal thymectomy. Preoperative clinical, pulmonary function, and respiratory muscle pressure data were submitted to stepwise logistic regression analysis to identify preoperative factors that correlated with duration of supported ventilation after surgery. Ten patients (31%) had postoperative supported ventilation for more than 3 days. The duration of ventilatory support correlated most closely with maximal static expiratory pressure (r = 0.714, p < 0.001). Expiratory weakness, by reducing cough efficacy, seems to be the main determinant that predicts need for longer postoperative supported ventilation. NEUROLOGY

Address correspondence and reprint requests to Dr. N.M.T. Braun, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam Avenue, New York, NY 10025.

Supported by Myasthenia Gravis Foundation Henry Viets Fellowship (Dr. Younger), and National Institutes of Health Pulmonary Academic Award HL00371 (Dr. Braun).

Accepted for publication June 24, 1983.




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