Acute Neuromuscular Respiratory Failure

Abstract

The clinician faces challenging diagnostic and treatment decisions when confronted with patients exhibiting oropharyngeal or respiratory weakness related to acute neuromuscular disorders. The primary concern is ascertaining the degree of neuromuscular respiratory failure and deciding whether there is a need for invasive or non-invasive ventilator support, or if close monitoring is required in the intensive care unit (ICU). Concomitantly, the search for the etiology driving the neuromuscular respiratory failure or the reason why a previously controlled neuromuscular condition worsened must be initiated. This chapter addresses these difficult questions the clinician faces when encountering a patient with neuromuscular respiratory failure by summarizing the clinical presentation, pathophysiology, and management of the condition. Additionally, the most common causes of primary neuromuscular respiratory failure, Guillain-Barré syndrome (GBS) and myasthenia gravis (MG), as well as the most common cause of secondary neuromuscular respiratory failure, critical illness neuromyopathy (CINM), will be discussed.