Variables Predicting Reintubation After Thymectomy in Patients With Myasthenia Gravis

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Estat

Patrocinadors

First Affiliated Hospital, Sun Yat-Sen University

ASSAIG CLÍNIC: NCT03597373

BioSeek: nct03597373

Paraules clau

Resum

Myasthenia gravis (MG) is an autoimmune disease that is characterized by muscle weakness and fatigue. The role of the thymus in MG has been suggested by the evidence that 10% to 15% of patients present with a thymoma and at least 60% with thymus hyperplasia or dysplasia.Beneficial effects of thymectomy in patients with MG have been described in 40% to 90%.Few studies have looked at the incidence of reintubation (not just within 24 hours after extubation), the factors associated with reintubation, and patient outcome.

Premature extubation may lead to hypercarbia, hypoxemia, pulmonary hypertension, right heart failure, and myocardial ischemia. Additionally, it subjects the patient to the physical risks of reintubation, including esophageal intubation, laryngeal trauma, and pulmonary aspiration. The purpose of the present study was to determine the incidence of reintubation, the variables associated with reintubation, and patient outcome

Descripció

Inclusion was based on the availability of all the following possible predictive pre-operative variables: age, gender, weight, height, body mass index, diabetes, creatinine, duration of MG, severity of MG (based on Osserman's classification), pathological type of MG, history of myasthenic crisis, dose of pyridostigmine, use of a steroid hormone, and use of an immunosuppressant.operative variables: postoperative pulmonary infection, total duration of hospital stay, duration of ICU stay, and duration of postoperative hospital stay. Variables were collected by research assistants and maintained in a computer database.

Dates

Darrera verificació:	06/30/2018
Primer enviat:	07/12/2018
Inscripció estimada enviada:	07/19/2018
Publicat per primera vegada:	07/23/2018
Última actualització enviada:	07/19/2018
Publicació de l'última actualització:	07/23/2018
Data d'inici de l'estudi real:	12/31/2016
Data estimada de finalització primària:	12/31/2018
Data estimada de finalització de l’estudi:	12/31/2018

Condició o malaltia

Myasthenia Gravis

Intervenció / tractament

Other: reintubation

Fase

Grups de braços

Braç	Intervenció / tractament
reintubation Reestablish of invasive mechanical ventilation
not reintubation Favourable respiratory function

Criteris d'elegibilitat

Edats elegibles per estudiar	18 Years Per a 18 Years
Sexes elegibles per estudiar	All
Mètode de mostreig	Probability Sample
Accepta voluntaris saludables	Sí
Criteris	Inclusion Criteria: - younger than 75 years - absence of heart failure as the primary indication for mechanical ventilation •Acute Physiology and Chronic Health Evaluation (APACHE) II score less than 12 points on day of extubation - body mass index less than 30 Exclusion Criteria: •preoperative moderate-to-severe chronic obstructive pulmonary disease

Resultat

Mesures de resultats primaris

1. Risk Factors for Reintubation [an average of 30 days]

the reintubation rate was analyzed with logistic regression

Variables Predicting Reintubation After Thymectomy in Patients With Myasthenia Gravis

Paraules clau

miastènia greu

fatiga muscular

hypoxia

astènia

hiperplàsia

isquèmia

debilitat muscular

thymoma

insuficiència cardíaca

thymus hyperplasia

creatinina