Prevention of pulmonary complications in severe Guillain‐Barrá syndrome by early assisted ventilation

Abstract

Sixty‐seven patients with acute polyneuritis (Guillain‐Barrá syndrome) who required assisted ventilation (AV) were studied to determine the effect of early initiation of AV on the development of pulmonary complications in the subsequent week. Of 67 patients, 57 had ultimately a very low vital capacity (VC) of the lungs (less than 15 mL/kg) and, therefore, had disease of comparable severity. These were divided retrospectively into those in whom AV was started before their VC fell below 15 mL/kg (“early” group) and those who received AV only after their VC was 15 mL/kg or lower (“late” group). The development of lung abnormalities demonstrated on chest x‐rays was compared in the two groups. Patients in the “early” group were less likely to develop pulmonary complications than those in the “late” group (P<0.0005). The beneficial effect of early AV was even greater if it was begun when the VC was higher than 25 mL/kg. The early initiation of AV in patients with Guillain‐Barrá syndrome and progressive respiratory paralysis reduces the risk of pulmonary complications.