The Characteristics and Duration of Mechanical Ventilator Use on Patient with Neuromuscular Paralysis Diseases in Intensive Care Unit (ICU) Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar in December 2019 - December 2022

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS), Guillain-Barre Syndrome (GBS), and Myasthenia Gravis (MG) are neuromuscular diseases which involved the dysfunction of peripheral nerves or muscles. Respiratory muscle weakness often happens in neuromuscular diseases, where it leads to the requirement of mechanical ventilation or even death from respiratory failure. This study aims to determine the characteristics and duration of mechanical ventilator usage in patients with neuromuscular paralysis diseases at Prof. Dr. I.G.N.G. Ngoerah General Hospital Denpasar. Results: From December 2019 to December 2022, there were 5 GBS patients (20%), 19 MG crisis patients (76%), and 1 ALS patient (4%). The mean of age was 40.8 years and the majority was female. The average duration of ventilator use in GBS patients was 25.8 days, in MG crisis was 26.2 days, and in ALS was 30 days, therefore all of them were prolonged. The outcomes were 3 GBS patients (12%) lived and 2 GBS patients (8%) died; 14 MG crisis patients (56%) lived and 5 MG crisis patients (20%) died; and 1 ALS patient (4%) died. The ICU diagnosis which complicated the patients were electrolyte disturbances, hypoalbuminemia, and community or ventilator acquired pneumonia. Conclusion: Neuromuscular disease mostly causes respiratory muscle weakness and results in increased mortality and morbidity requiring mechanical ventilation. Risk factors affecting the prolonged duration of ventilator use were electrolyte disturbances, hypoalbuminemia, and pneumonia. Keywords: length of ventilator usage, neuromuscular paralysis disease, amyotrophic lateral sclerosis, Guillain-Barre syndrome, myasthenia gravis, intensive care unit, Bali