Case Report: EAdi-guided ventilatory management leads to successful extubation in a pediatric myasthenic disorder

Monitoring of diaphragmatic electrical activity (EAdi) may provide real-time insight into neural respiratory drive, but data in pediatric myasthenic disease are scarce. We report a 2-year-old girl requiring mechanical ventilation for respiratory failure due to an initial diagnosis of myasthenic syndrome. Following initiation and escalation of pyridostigmine, median EAdi rose from 1.69 to 7.7 µV while ventilatory support was simultaneously reduced, resulting in successful extubation after 5 days. This case illustrates the potential added value of EAdi monitoring alongside conventional ventilator parameters in tracking neuromuscular recovery during weaning.