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Specific treatment has been shown to shorten the duration of mechanical ventilation in Guillain-Barre syndrome (GBS) and could obviate the need for tracheostomy in a significant proportion of patients. However, the factors predictive of pr olonged ventilation are undetermined, and the timing and use of tracheostomy in patients with GBS have not been systematically studied. The medical records of 60 patients ventilated for GBS were reviewed. Only 13 patients (22%) could be weaned within 3 weeks. Patients ventilated longer were significantly older (P = 0.04), and 21% had underlying pulmonary disease. Median duration of ventilation in patients treated with plasma exchange (n-31) was not shortened. Fifty-two patients (87%) received a trach eostomy at a median of 9 days after intubation. In this series, where patients with comorbidity were included, tracheostomy was still necessary in the majority of ventilated patients. This procedure can be anticipated in elderly patients and in the pre sence of preexisting pulmonary disease. |
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