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Document Type

Original Article

Abstract

Guillain-Barre’ Syndrome is the most common cause of acute flaccid paralysis worldwide. One of the most serious complications is respiratory failure warranting mechanical ventilation which is required in about 30% of the patients. Various studies have been carried out to identify clinical factors which could help identify patients with impending respiratory failure and facilitate elective mechanical ventilation in these patients to reduce the associated mortality. Material and methods: 92 patients diagnosed with GBS were enrolled from February 6, 2013 to August 5, 2013 in department of Neurology, PIMS, Islamabad. Each patient was then be managed accordingly and monitored for therequirement of ventilatory support. Based on the need of Mechanical ventilation patients were divided in to 2 groups: ventilated (Group 1) and non-ventilated (Group 2) and presence of various clinical factors were assessed in both groups. Results: The mean age of patients was 33.83 ± 16.91 years with a male preponderance (68.48%). 31 (33.7%) patients of GBS needed mechanical ventilation.Patients requiring mechanical ventilation tended to have more severe disease evidenced by the presence of bulbar dysfunction (P=.000), autonomic dysfunction (P = .000), and upper limb paralysis (P = .010). The presence of a preceding gastrointestinal illness did not prove to be an independent predictor of mechanical ventilation on multivariate analysis. Conclusion: The course of patients with severe GBS leading to mechanical ventilation can, to some extent, be predicted on the basis of clinical factors. This study identifies bulbar dysfunction and dysautonomia as significant independent predictors of mechanical ventilation.

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