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Emergency intubation for respiratory failure in Guillain-Barré syndrome
Eelco F M Wijdicks1, Robert D Henderson, Robyn L McClelland
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. wijde@mayo.edu
Background:
The consequences of emergency intubation in Guillain-Barré syndrome are not known.
Objective:
To review data from patients admitted to the intensive care unit with recent diagnosis of Guillain-Barré syndrome and intubation for respiratory failure.
Design, Setting, And Patients:
The database of patients with Guillain-Barré syndrome admitted to the intensive care units during the past 2 decades was reviewed. Emergency intubation was defined as need for ventilation in a patient with sudden dyspnea, cyanosis, or respiratory arrest. Outcome and pulmonary morbidity were assessed by comparing these patients with patients intubated electively.
Results:
Six patients were intubated for acute respiratory distress and 1 patient for respiratory arrest. Thirty-six patients were intubated electively. Prolonged weaning was twice as common in the emergent group as in the elective group; a larger sample size might have demonstrated statistical significance. One patient with respiratory arrest developed marked anoxic encephalopathy; in all others, no differences were found in mortality, pulmonary morbidity, or duration of ventilatory assistance. None of the emergency intubations occurred in the last 15 years of the study.
Conclusions:
Emergency intubation in Guillain-Barré syndrome is uncommon but, when associated with respiratory arrest, can lead to anoxic encephalopathy. Duration of ventilator use and pulmonary morbidity are not increased in these patients.