Guillain-Barré syndrome: management of respiratory failure.
Nineteen of 38 consecutive patients with Guillain-Barré syndrome were treated with mechanical ventilation in a neurological ICU. A ventilator was used for expiratory vital capacity (VC) below 12 to 15 ml/kg or arterial PO2 below 70 mm Hg, or clinical signs of fatigue. Artificial ventilation was discontinued when VC reached 8 to 10 ml/kg. Twelve patients required tracheostomy at 11 days (mean) after intubation. Mechanical ventilation was required for 49 days (mean). Complications included pneumonia in 15 patients, mostly aspiration, only 1 severe; pulmonary embolus in 1 ventilated and 1 nonventilated patient; and tracheal stenosis in 1. There was one death in a previously unintubated patient who developed sepsis while improving from GBS, and no deaths in the 18 other intubated patients.
D000328:Adult; D000368:Aged; D006801:Humans; D007440:Intubation; D008875:Middle Aged; D011129:Polyradiculoneuropathy / Q000628:therapy*; D011655:Pulmonary Embolism / Q000209:etiology; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy*; D014140:Tracheotomy