BiPAP in early guillain-barré syndrome may fail.
BACKGROUND
Non-invasive mechanical ventilation (BiPAP) has been introduced for use in neuromuscular respiratory disease such as amyotrophic lateral sclerosis and myasthenia gravis. There is no experience in Guillain-Barré syndrome.


METHODS
We describe for the first time the use of BiPAP to assist in the work of breathing in two consecutive patients with progressing Guillain-Barré syndrome (GBS) and marginal pulmonary function.


RESULTS
Our initial attempts to use BiPAP in GBS and early neuromuscular respiratory failure were totally unsuccessful. There was marked initial improvement; however, emergency intubation was needed in both patients, one of which became acutely cyanotic.


CONCLUSIONS
Until more experience is available, we strongly warn against using BiPAP in deteriorating patients with GBS.
Department of Neurology, Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. wijde@mayo.edu
Eelco F M
EF
Wijdicks
Tuhin K
TK
Roy
D000368:Aged; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D017211:Treatment Failure