Approach to the Patient with Neuromuscular Diseases Causing Acute Respiratory Failure

This chapter is dedicated to the clinical presentation, diagnosis, pathophysiology, and treatment of neuromuscular respiratory failure in the intensive care unit. Attention to the patient’s history and clinical examination is paramount when identifying the correct diagnosis and promptly stabilizing and initiating the appropriate treatment course. Common neuromuscular pathologies that culminate in neuromuscular respiratory failure include acute inflammatory demyelinating polyneuropathy (AIDP) or Guillain-Barré syndrome (GBS) and myasthenia gravis (MG) but also include less common pathologies which are discussed herein. Neuromuscular respiratory failure requires expert evaluation and assessment to identify the underlying pathophysiology and understand the patient’s immediate clinical needs. Through a variety of clinical maneuvers and exam techniques, a skilled clinician can recognize and respond appropriately to the patient’s condition. Herein, we present our proposed clinical approach to the patient presenting with neuromuscular respiratory failure and an overview of the various disease processes that result in the condition. We share our clinical tools for their identification. Many of these disease processes have associated symptoms and signs that can be identified or anticipated during their hospital course. Further we will discuss therapeutic options for their management and treatment in the intensive care unit setting.