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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

CATALA RIPOLL, José Vicente et al. Role of ecography in diagnostic of postoperative acute respiratory failure after timectomy. Med. crít. (Col. Mex. Med. Crít.) [online]. 2018, vol.32, n.2, pp.108-110. ISSN 2448-8909.

Myasthenia gravis is an autoimmune disease that can alter the physical abilities of patients. Thymectomy is one of the therapeutic options. The postoperatory may be complicated by the disease itself or by intraoperative lesions of nerve structures. Case of 66-year-old woman with myasthenia gravis undergoing thymectomy. The left phrenic nerve was resected. In the immediate postoperative period, the patient presented acute respiratory failure. A lung ultrasound is performed, being anodyne. The diaphragmatic ultrasound proved a 10% of thickening fraction on the right side and absence of contractility on the left side. The patient required non-invasive mechanical ventilation for six days, tracheotomy was performed to succeed the respiratory weaning. The patient was transferred to ward in spontaneous ventilation. The diaphragmatic ultrasound is a useful and portable diagnostic technique, mainly in urgent situations due to the rapidity of its implementation. It complements the clinical assessment in the diagnosis of acute postoperative respiratory failure.

Palavras-chave : Diaphragm; myasthenia gravis; ultrasonography; thymectomy.

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