title: Neurally adjusted ventilatory assist during weaning from respiratory support in a case of guillain-barré syndrome.
abstract: We report a case of Guillain-Barré syndrome complicated by respiratory failure requiring mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) allowed proper patient-ventilator synchronization by pressure support proportional to the electrical activity of the diaphragm (Edi). Prolonged ventilation with NAVA seems feasible in patients with neuromuscular impairment, but the weaning process conducted by a continuous monitoring of Edi for pressure support titration needed to be assessed in a Guillain-Barré syndrome patient. Beginning on day 12 after hospital admission, the patient was ventilated with NAVA for 8 d. The NAVA level (pressure support per unit of Edi) was decreased from 1.2 cm H2O/μV to zero over the 8-d period. A simultaneous decrease in the tidal volume/Edi ratio was interpreted as a sign of recovery. A spontaneous breathing trial was successfully performed on day 20, followed by decannulation 4 d later. In conclusion, NAVA should be further investigated in patients with Guillain-Barré syndrome, particularly during the weaning period.
authors.affiliation: Department of Intensive Care Medicine, Cliniques Universitaires Saint-Luc.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dugernier
authors.affiliation: Department of Intensive Care Medicine, Cliniques Universitaires Saint-Luc.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bialais
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reychler
authors.affiliation: Department of Intensive Care Medicine, Cliniques Universitaires Saint-Luc.
authors.forename: Marco
authors.initials: M
authors.lastname: Vinetti
authors.affiliation: Department of Intensive Care Medicine, Cliniques Universitaires Saint-Luc philippe.hantson@uclouvain.be.
authors.forename: Philippe
authors.initials: P
authors.lastname: Hantson
mesh_terms: D000368:Aged; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications*; D006801:Humans; D059725:Interactive Ventilatory Support / Q000379:methods*; D011175:Positive-Pressure Respiration; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D015300:Ventilator Weaning / Q000379:methods*
keywords: Guillain-Barré syndrome; mechanical ventilation; neutrally adjusted ventilator assist; weaning