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. 2016 May;109(5):319-23.
doi: 10.1093/qjmed/hcv190. Epub 2015 Oct 15.

Outcome of Guillain-Barre syndrome patients with respiratory paralysis

J Kalita  1 , A Ranjan  1 , U K Misra  2
Affiliations

Outcome of Guillain-Barre syndrome patients with respiratory paralysis

J Kalita et al. QJM. 2016 May.

Abstract

Background and aims: To evaluate the outcome of patients with Guillain -: Barre syndrome (GBS) having respiratory failure treated with modified intubation policy.

Design and 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.

Conclusion: In GBS patients with respiratory compromise, conservative intubation does not increase mortality and disability.

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Figures

Figure 1.
Figure 1.
Subtypes of Guillain–Barre syndrome with respiratory compromise who needed mechanical ventilation and those who did not.
Figure 2.
Figure 2.
The mechanically ventilated (MV) Guillain–Barre patients had insignificantly higher mortality and poor outcome compared with the patients who did not require MV although had respiratory compromise.
See this image and copyright information in PMC

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