Encouraging results from the ventilatory weaning protocol during myasthenic crises

French clinicians involved in weaning myasthenic patients undergoing decompensation (myasthenic crisis) report the results of the WEAN Safe protocol applied to a single-center cohort (Paris, Salpêtrière):

• of the 698 admissions to intensive care for this reason, only the records of 81 patients covering the period 2008-2023 were selected for the study,
• the median age of patients was 70 years, with a higher proportion of men, two-thirds of whom were cases of very late-onset myasthenia gravis (> 65 years),
• according to the WEAN Safe classification, 3% of patients had rapid weaning, 40% had medium-term weaning, 55% experienced prolonged weaning, and 3% could not be weaned.
• The late onset of myasthenia gravis did not influence the results.
• However, the presence of thymoma and/or the absence of prior immunosuppressive treatment were associated with a poorer prognosis.

 

Weaning from mechanical ventilation in myasthenic crisis according to WEAN safe: most patients experience intermediate or prolonged weaning with no differences between early and late-onset compared to very-late onset myasthenia Gravis. Marois C, Combes A, Bouguerra M et al. Ann Intensive Care. 2025 Jul 14;15(1):95.