Department of Neurology, First Hospital of Jilin University , Changchun, China.
Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine and Science , Rochester, MN, USA.
Expert Rev Clin Immunol. 2020 Nov;16(11):1053-1064. doi: 10.1080/1744666X.2021.1840355. Epub 2020 Nov 25.
: Up to 30% of patients with GuillainBarré syndrome (GBS) develop respiratory failure requiring intensive care unit (ICU) admission and mechanical ventilation. Progressive weakness of the respiratory muscles is the leading cause of acute respiratory distress and respiratory failure with hypoxia and/or hypercarbia. Bulbar weakness may compromise airway patency and predispose patients to aspiration pneumonia. : Clinical questions related to the use of mechanical ventilation include but are not limited to: When to start? Invasive or noninvasive? When to wean from mechanical ventilation? When to perform tracheostomy? How to manage complications of GBS in the ICU including nosocomial infection, ventilator-associated pneumonia, and ICU-acquired weakness? In this narrative review, the authors summarize the up-to-date knowledge of the incidence, pathophysiology, evaluation, and general management of respiratory failure in GBS. : Respiratory failure in GBS merits more attention from caregivers. Emergency intubation may lead to life-threatening complications. Appropriate methods and time point of intubation and weaning, an early tracheostomy, and predictive prophylaxis of complications benefit patients' long-term prognosis.
高达 30%的吉兰-巴雷综合征（GBS）患者会发展为需要入住重症监护病房（ICU）并接受机械通气的呼吸衰竭。呼吸肌进行性无力是导致急性呼吸窘迫和缺氧/高碳酸血症性呼吸衰竭的主要原因。球麻痹可使气道通畅性受损，并使患者易发生吸入性肺炎。
何时开始？有创还是无创？何时从机械通气中撤机？何时进行气管切开术？如何在 ICU 中管理 GBS 的并发症，包括医院获得性感染、呼吸机相关性肺炎和 ICU 获得性肌无力？在这篇叙述性综述中，作者总结了 GBS 患者呼吸衰竭的发病率、病理生理学、评估和一般管理的最新知识。
GBS 导致的呼吸衰竭需要护理人员更多的关注。紧急插管可能会导致危及生命的并发症。适当的插管和撤机方法和时间点、早期气管切开术以及并发症的预防性治疗都有利于患者的长期预后。
