Emergency intubation for respiratory failure in Guillain-Barré syndrome.

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.