title: Outcome of Guillain-Barre syndrome patients with respiratory paralysis.
abstract: OBJECTIVE
  To evaluate the outcome of patients with Guillain -: Barre syndrome (GBS) having respiratory failure treated with modified intubation policy.
  
  
  METHODS
  Consecutive patients with GBS having single breath count below 12 and respiratory rate >30/min were included and their clinical details noted. The patients were intubated and mechanically ventilated (MV) if their PaO2 was <60 mmHg on venturi mask, PaCo2 > 50 mmHg or pH < 7.3. Their electrophysiological subtypes and complications were noted. The hospital mortality and 3 months outcome were compared in MV and those could be managed without MV even with respiratory compromise.
  
  
  RESULTS
  Out of 369 patients, 102 (27.6%) patients had respiratory compromise who were included in this study. Of the patients with respiratory compromise, 44 (43.1%) were intubated and mechanically ventilated after a median of 4 days of hospitalization. The median duration of MV was 21 (range 1-88) days. The patients with autonomic dysfunction (56.8% vs. 19%), facial weakness (78% vs. 36.2%), bulbar weakness (81.8% vs. 31%), severe weakness (63.8% vs. 31%) and high transaminase level (47.7% vs. 25.9%) needed MV more frequently. In our study, 6.8% patients died and 26.6% had poor outcome which was similar between MV and non-MV patients. The MV patients had longer hospitalization and more complications compared with non-MV group.
  
  
  CONCLUSIONS
  In GBS patients with respiratory compromise, conservative intubation does not increase mortality and disability.
authors.affiliation: From the Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, 226014, India.
authors.forename: J
authors.initials: J
authors.lastname: Kalita
authors.affiliation: From the Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, 226014, India.
authors.forename: A
authors.initials: A
authors.lastname: Ranjan
authors.affiliation: From the Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, 226014, India drukmisra@rediffmail.com ukmisra@sgpgi.ac.in.
authors.forename: U K
authors.initials: UK
authors.lastname: Misra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D018450:Disease Progression; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods; D012133:Respiratory Paralysis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult