Аннотация
Миастенический криз (МК) – редкое и потенциально опасное осложнение миастении гравис, требующее интенсивной терапии в условиях отделения анестезиологии и реанимации (ОАИР). МК проявляется нарастанием острой дыхательной недостаточности на фоне прогрессирующего снижения тонуса дыхательной мускулатуры и параллельной гипотонией бульбарных мышц. К симптоматической терапии относят введение ингибиторов ацетилхолинэстеразы, быстрая иммуномодулирующая терапия (иммуноадсорбция и плазмаферез), назначение глюкокортикостероидов и иммунодепрессантов (азатиоприн, ритуксимаб, экулизумаб). При отсутствии эффекта переходят к респираторной поддержке – неинвазивной или искусственной вентиляции лёгких с интубацией трахеи. Повышение информированности о МК и чёткое следование терапевтическим алгоритмам улучшат качество оказания экстренной помощи данному контингенту пациентов. Цель обзора – анализ и обсуждение современной зарубежной литературы, посвящённой вопросам интенсивной терапии МК в условиях ОАИР.
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