Myasthenia Crisis Management in the ICU: A Case Report

Dhita Natasha Dwiriyanti; Novita Anggraeni

doi:10.61860/jigp.v4i2.316

Authors

Dhita Natasha Dwiriyanti Department of Anesthesiology, Faculty of Medicine, University of Riau, Pekanbaru, Indonesia
Novita Anggraeni Department of Anesthesiology, Faculty of Medicine, University of Riau, Pekanbaru, Indonesia

DOI:

https://doi.org/10.61860/jigp.v4i2.316

Abstract

This study focuses on analyzing the clinical course of myasthenic crisis in post-thymomectomy patients by examining the triggering factors, physiological responses, and the effectiveness of multidisciplinary interventions in stabilization and recovery. The research method used was an in-depth clinical case study that monitored the patient's condition from the acute phase to the weaning phase through direct observation, medical data analysis, and tracking of the therapeutic interventions provided. The results showed that myasthenic crisis was influenced by a combination of nosocomial infection, severe neuromuscular weakness, electrolyte disturbances, and acute respiratory failure. Each intervention from emergency intubation, aggressive antibiotic therapy, hypokalemia correction, IVIG administration, to respiratory physiotherap contributed directly to the improvement of respiratory function and hemodynamic stability. This study provides important implications that myasthenic crisis is a systemic condition that requires rapid decision-making, a structured therapeutic approach, multi-layered monitoring, and cross-professional integration. In addition to strengthening the global literature, these findings emphasize the value of early identification of triggering factors and metabolic correction as key to accelerating recovery, while also opening up space for further research with larger sample sizes to develop more comprehensive clinical guidelines.

Downloads

Download data is not yet available.

References

Atmaja, I. M. B., Rahmat, D., & Hunaifi, I. (2022). Krisis Miastenik: Literature Review. Jurnal Kesehatan Qamarul Huda, 10(2), 169–176.

Basuki, R., Musyahidah, M., Risnawati, A., & Sumiati, B. (2025). Kesehatan Lingkungan dan Kesehatan Kerja: Paparan, Risiko, dan Strategi Mitigasi. PT Mafy Media Literasi Indonesia.

Bruno, R. R., Wolff, G., Wernly, B., Masyuk, M., Piayda, K., Leaver, S., Erkens, R., Oehler, D., Afzal, S., & Heidari, H. (2022). Virtual and augmented reality in critical care medicine: the patient’s, clinician’s, and researcher’s perspective. Critical Care, 26(1), 326.

Hamzens, M. F. (2024). Antropologi Kesehatan: Teori dan Aplikasi Intervensi Kesehatan. Mega Press Nusantara.

Hidayanti, D., Wilyo, F. A., Saragih, M., Setyaningrum, O., & Rinaldo, A. (2023). Patofisiologi Penyakit Meniere pada Pasien Autoimun: Tinjauan Literatur. Health Information: Jurnal Penelitian, e1061–e1061.

Inayah, A. F., Yusetyani, L., Purnama, P. A., & Utari, N. (2022). Profil terapi imunosupresan pada pasien anak dengan lupus nefritis. MOTORIK Journal Kesehatan, 17(1), 8–12.

Jasmin Ambas, S. K. M., Rahman, E., Sos, S., Siswati, S., SH, A., Tahir, A., Amin, A. N., Laksono, R. D., SpPD, M., & FINASIM, S. H. (2025). Manajemen Pelayanan Sektor Publik (Teori dan Praktek Layanan Publik di Rumah Sakit). MEGA PRESS NUSANTARA.

Latuconsina, N. A., SKM, M. K., Salim, N. A., SKM, M. P. H., Mubarak, F., Farm, S., La Ode Muhammad Ady Ardyawan, S., Santi, S. K. M., Daud, A. C., & SKM, M. K. (2023). Manajemen Rumah Sakit. CV Eureka Media Aksara.

Lloyd, E. M., Pinniger, G. J., Murphy, R. M., & Grounds, M. D. (2023). Slow or fast: Implications of myofibre type and associated differences for manifestation of neuromuscular disorders. Acta Physiologica, 238(4), e14012.

Muhammad, H. Y. (2022). Eksplorasi Faktor-Faktor Penyebab Terjadinya High Volume, High Risk, dan High Cost pada Lima Penyakit dan Pengembangan Format Integrated Clinical Pathway di RSUD Kabupaten Banggai= Exploration of causative factor High Volume, High Risk, and High Cost at Five Diseases and Development of Integrated Clinical Pathway Format in Banggai District Hospital. Universitas Hasanuddin.

Mulyadi, E. M., Sari, N. D., Dewi, H. K., Mufadhdhal, R. A., & Suprabowo, S. H. (2024). Manajemen krisis Myasthenia: case report. Health Sciences and Pharmacy Journal, 8(2), 113–118.

Narayanaswami, P., Sanders, D. B., Wolfe, G., Benatar, M., Cea, G., Evoli, A., Gilhus, N. E., Illa, I., Kuntz, N. L., & Massey, J. (2021). International consensus guidance for management of myasthenia gravis: 2020 update. Neurology, 96(3), 114–122.

Nelson, R., Kesterson, K., Schofield, J., & Blitshteyn, S. (2022). Immunotherapy With Subcutaneous Immunoglobulin or Plasmapheresis in Patients With Postural Orthostatic Tachycardia Syndrome (POTS). Neurology, 99(23_Supplement_2), S68–S69.

Nurhayati, W. (2025). Perbedaan Luaran Motorik Pasien Sindroma Guillain Barré Dengan Terapi IVIg dan Plasmaferesis. Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 41(2).

Poltak, H., & Widjaja, R. R. (2024). Pendekatan metode studi kasus dalam riset kualitatif. Local Engineering, 2(1), 31–34.

Putra, K. A. H., Lesmana, P. M., & Senapathi, T. G. A. (2025). Efektivitas Blok Nervus Maksilaris Suprazigomatika pada Pasien Miastenia Gravis yang Menjalani Functional Endoscopic Sinus Surgery (FESS). Majalah Anestesia & Critical Care, 43(3), 266–274.

Putri, H. M., Windarti, I., Mayasari, D., & Susianti, S. (2024). Eksplorasi Imunoterapi dan Terapi Gen dalam Pengobatan Tumor Otak: Literature Review. Medical Profession Journal of Lampung, 14(12), 2229–2235.

Salsabila, K., Mutiara, H., & Hanriko, R. (2023). Miastenia Gravis: Etiologi, Patofisiologi, Manifestasi Klinis, Penegakkan Diagnosis dan Tatalaksana. Medical Profession Journal of Lampung, 13(1), 115–121.

Sarılar, A. Ç., Köseoğlu, E., Eröz, Ç., Gülmez, G., Oğuzkaya, F., & Polat, B. S. A. (2022). Myastenia Gravis Hastalarında Timektominin Klinik İyileşmeye Etkisi. Sürekli Tıp Eğitimi Dergisi, 31(1), 50–56.

Somaa, F. A., de Graaf, T. A., & Sack, A. T. (2022). Transcranial magnetic stimulation in the treatment of neurological diseases. Frontiers in Neurology, 13, 793253.

Zain, A., Akram, M. S., Ashfaq, F., Ans, A., Ans, H. H., & Ans, H. (2024). Comparative Analysis of Intravenous Immunoglobulins (IVIg) vs Plasmapheresis (PLEX) in the Management of Myasthenic Crisis. Cureus, 16(9).