Pearls and pitfalls in the intensive care management of Guillain-Barré syndrome

Approximately one third of patients with Guillain-Barré syndrome (GBS) need to be admitted to the intensive care unit (ICU) because of respiratory failure. A significant proportion of patients require ICU admission because of dysautonomia or because of medical or iatrogenic complications. Recognition of the clinical manifestations and the paraclinical findings in patients with neuromuscular respiratory failure is essential to ensure mechanical ventilation promptly. In the ICU, attention to positioning, nutrition, analgesia, and psychological support are crucial. Recognition of autonomic dysfunction and of the rare need for intervention is important to avoid iatrogenic complications. Prognosis determination in GBS is based on the clinical history, epidemiological factors, and neurologic examination.