Cardiac disorders worsen the final outcome in myasthenic crisis undergoing non-invasive mechanical ventilation: a retrospective 20-year study from a single center

This study looked back over a 20-year period at a single medical center in Modena, Italy, and examined the impact of cardiac disorders on the outcomes of myasthenic crisis (MC) patients requiring non-invasive mechanical ventilation (aka BIPAP). The study included 90 cases of MC admitted to the Neurology Unit, and the researchers analyzed the effect of cardiac comorbidities on various outcomes such as the need for invasive ventilation, the risk of tracheostomy due to weaning failure, and the duration of intensive care unit (ICU) stay. The results indicated that atrial fibrillation (AF), hypertensive cardiopathy (HHD), and ischemic heart disease (IHD) were independent predictors of non-invasive ventilation (NIV) failure in MC patients. Hypertension (HT) did not significantly affect the outcomes, while HHD was associated with a higher risk of weaning failure (unable to come off of the ventilator). The study suggests that cardiac disorders like AF, HHD, and IHD can increase the risk of NIV failure in MC patients receiving ventilation.