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Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial

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Title: Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial
Authors: Marie-Anne Melone, Nicholas Heming, Paris Meng, Dominique Mompoint, Jerôme Aboab, Bernard Clair, Jerôme Salomon, Tarek Sharshar, David Orlikowski, Sylvie Chevret, Djillali Annane
Source: Annals of Intensive Care, Vol 10, Iss 1, Pp 1-9 (2020)
Publisher Information: SpringerOpen, 2020.
Publication Year: 2020
Collection: LCC:Medical emergencies. Critical care. Intensive care. First aid
Subject Terms: Guillain-Barré syndrome, Acute respiratory failure, Intubation, Mechanical ventilation, Aspiration, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
More Details: Abstract Introduction About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. Methods This was a single centre, open-label, randomized controlled trial performed on two parallel groups. 50 intensive care unit adults admitted for Guillain-Barré syndrome and at risk for acute respiratory failure. Patients were randomized to early mechanical ventilation via face-mask or endotracheal intubation owing to the presence or absence of impaired swallowing (experimental arm), or to conventional care (control arm). The primary outcome was the incidence of pneumonia up to intensive care unit discharge (or 90 days, pending of which occurred first). Findings Twenty-five patients were randomized in each group. There was no significant difference between groups for the incidence of pneumonia (10/25 (40%) vs 9/25 (36%), P = 1). There was no significant difference between groups for the time to onset of pneumonia (P = 0.50, Gray test). During follow-up, there were 16/25 (64%) mechanically ventilated patients in the control group, and 25/25 (100%) in the experimental arm (P
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2110-5820
Relation: http://link.springer.com/article/10.1186/s13613-020-00742-z; https://doaj.org/toc/2110-5820
DOI: 10.1186/s13613-020-00742-z
Access URL: https://doaj.org/article/5158b9ca66344655ae5221fd0aad2e0f
Accession Number: edsdoj.5158b9ca66344655ae5221fd0aad2e0f
Database: Directory of Open Access Journals
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  Data: Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial
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  Data: <searchLink fieldCode="AR" term="%22Marie-Anne+Melone%22">Marie-Anne Melone</searchLink><br /><searchLink fieldCode="AR" term="%22Nicholas+Heming%22">Nicholas Heming</searchLink><br /><searchLink fieldCode="AR" term="%22Paris+Meng%22">Paris Meng</searchLink><br /><searchLink fieldCode="AR" term="%22Dominique+Mompoint%22">Dominique Mompoint</searchLink><br /><searchLink fieldCode="AR" term="%22Jerôme+Aboab%22">Jerôme Aboab</searchLink><br /><searchLink fieldCode="AR" term="%22Bernard+Clair%22">Bernard Clair</searchLink><br /><searchLink fieldCode="AR" term="%22Jerôme+Salomon%22">Jerôme Salomon</searchLink><br /><searchLink fieldCode="AR" term="%22Tarek+Sharshar%22">Tarek Sharshar</searchLink><br /><searchLink fieldCode="AR" term="%22David+Orlikowski%22">David Orlikowski</searchLink><br /><searchLink fieldCode="AR" term="%22Sylvie+Chevret%22">Sylvie Chevret</searchLink><br /><searchLink fieldCode="AR" term="%22Djillali+Annane%22">Djillali Annane</searchLink>
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  Data: Annals of Intensive Care, Vol 10, Iss 1, Pp 1-9 (2020)
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  Data: Abstract Introduction About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumonia occurrence in GBS patients. We hypothesize that EMV will reduce the incidence of pneumonia. Methods This was a single centre, open-label, randomized controlled trial performed on two parallel groups. 50 intensive care unit adults admitted for Guillain-Barré syndrome and at risk for acute respiratory failure. Patients were randomized to early mechanical ventilation via face-mask or endotracheal intubation owing to the presence or absence of impaired swallowing (experimental arm), or to conventional care (control arm). The primary outcome was the incidence of pneumonia up to intensive care unit discharge (or 90 days, pending of which occurred first). Findings Twenty-five patients were randomized in each group. There was no significant difference between groups for the incidence of pneumonia (10/25 (40%) vs 9/25 (36%), P = 1). There was no significant difference between groups for the time to onset of pneumonia (P = 0.50, Gray test). During follow-up, there were 16/25 (64%) mechanically ventilated patients in the control group, and 25/25 (100%) in the experimental arm (P
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