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BiPAP in Early Guillain-Barré Syndrome May Fail

Published online by Cambridge University Press:  02 December 2014

Eelco F.M. Wijdicks  and
Tuhin K. Roy
Eelco F.M. Wijdicks*
Affiliation:
Department of Neurology, Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
Tuhin K. Roy
Affiliation:
Department of Anesthesiology, Division of Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
*
Mayo Clinic College of Medicine, Department of Neurology, W8B, 200 First Street SW, Rochester, Minnesota 55905 USA. E-mail: wijde@mayo.edu
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Abstract:

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Background:

Non-invasive mechanical ventilation (BiPAP) has been introduced for use in neuromuscular respiratory disease such as amyotrophic lateral sclerosis and myasthenia gravis. There is no experience in Guillain-Barré syndrome.

Methods:

We describe for the first time the use of BiPAP to assist in the work of breathing in two consecutive patients with progressing Guillain-Barré syndrome (GBS) and marginal pulmonary function.

Results:

Our initial attempts to use BiPAP in GBS and early neuromuscular respiratory failure were totally unsuccessful. There was marked initial improvement; however, emergency intubation was needed in both patients, one of which became acutely cyanotic.

Conclusions:

Until more experience is available, we strongly warn against using BiPAP in deteriorating patients with GBS.

Résumé

RÉSUMÉ Contexte:

La ventilation mécanique non effractive (BiPAP) est utilisée dans les maladies neuromusculaires avec atteinte respiratoire comme la sclérose latérale amyotrophique et la myasthénie grave. Cependant, il n'y a pas de données sur le syndrome de Guillain-Barré (SGB).

Méthodes:

Nous décrivons pour la première fois l'utilisation du BiPAP pour fournir une assistance respiratoire chez deux patients consécutifs présentant un (SGB) évolutif et une fonction pulmonaire limite.

Résultats:

Nos premières tentatives d'utilisation du BiPAP dans le SGB avec insuffisance respiratoire neuromusculaire au début se sont soldées par un échec. L'amélioration initiale était importante, cependant une intubation d'urgence s'est avérée nécessaire chez les deux patients, dont un est devenu subitement cyanosé.

Conclusions:

Tant qu'il n'y a pas plus de données à ce sujet, nous décourageons fortement son utilisation chez les patients atteints d'un SGB évolutif.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 33 , Issue 1 , February 2006 , pp. 105 - 106
Copyright
Copyright © The Canadian Journal of Neurological 2006

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