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Age-Related Differences in Respiratory Outcomes Among Critically Ill Children with Guillain-Barré Syndrome

Bradley J De Souza1, Ola Kassis2, Deepti Nagesh3

  • 1Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA; Keck School of Medicine, University of Southern California, Los Angeles, CA.

The Journal of Pediatrics
|August 9, 2025
PubMed

Insights

Younger children with Guillain-Barré syndrome (GBS) are more likely to need mechanical ventilation (MV) but have shorter durations and lower tracheostomy rates. These age-related respiratory outcome differences in critically ill children with GBS can inform clinical care.

Area of Science:

  • Pediatric critical care medicine
  • Neurology
  • Respiratory medicine

Background:

  • Guillain-Barré syndrome (GBS) is a rare neurological disorder that can cause respiratory muscle weakness.
  • Critically ill children with GBS may require mechanical ventilation (MV) and tracheostomy.
  • Age-related differences in GBS respiratory outcomes are not well-defined.

Purpose of the Study:

  • To evaluate age-related differences in respiratory outcomes for critically ill children with GBS.
  • To compare mechanical ventilation (MV) requirements and tracheostomy rates across different age groups.

Main Methods:

  • Retrospective cohort study using the Virtual Pediatric Systems registry (2009-2020).
  • Included US children (<21 years) diagnosed with GBS and admitted to an intensive care unit (ICU).
  • Primary outcome: invasive mechanical ventilation (IMV); Secondary outcomes: MV duration and tracheostomy.

Main Results:

  • Of 497 children with GBS, 37.2% required IMV, and 9.1% received a tracheostomy.
  • Younger children (<12 years) had higher odds of requiring IMV compared to older children.
  • Younger children experienced shorter MV durations and lower tracheostomy rates.

Conclusions:

  • Most critically ill children with GBS in the US do not require MV; initiation is typically within 24 hours of ICU admission.
  • Significant age-related variations exist in respiratory outcomes for pediatric GBS patients.
  • These findings can help guide clinical management strategies for GBS in children.
Abstract

Keywords:
Guillain-Barré syndromelength of stayrespiratory insufficiencytracheostomy

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