Mechanical Ventilation

Predictors of ET Mechanical Ventilation

• Time from onset to admission < 7 days
• Inability to cough
• Inability to stand
• Inability to life elbows
• Inability to lift head
• Increased liver enzyme
• Vital capacity under 60%

Mechanical ventilation is required in 85% of patients with at least 4 predictors.

Criteria for Mechanical Ventilation

• Major criteria
• Vital capacity < 15mL/kg
• PaCO2 > 6.4kPa on room air
• PaO2 < 7.5kPa on room air
• Intolerable respiratory distress
• Minor criteria
• Atelectasis
• Aspiration
• Inability to clear secretions with PT
• Inefficient cough

Mechanical ventilation is indicated with either one major criterion or two minor criteria.

Complications (Truax, 1984)

• Pneumonia
• Early onset pneumonia is common (78%) and severe
• Delaying intubation may increase risk (Orlikowski et al, 2006)
• Tracheobronchitis
• Pulmonary embolus
• Bacteraemia
• HTN in 1/3 of GBS patients
• Urinary retention in up to 1/3 of GBS patients
• Difficulty with GI motility in approx. 15% of severely affected GBS patients.