• Eelco F M Wijdicks and Tuhin K Roy.
• Department of Neurology, Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. wijde@mayo.edu
• Can J Neurol Sci. 2006 Feb 1;33(1):105-6.

BackgroundNon-invasive mechanical ventilation (BiPAP) has been introduced for use in neuromuscular respiratory disease such as amyotrophic lateral sclerosis and myasthenia gravis. There is no experience in Guillain-Barré syndrome.MethodsWe describe for the first time the use of BiPAP to assist in the work of breathing in two consecutive patients with progressing Guillain-Barré syndrome (GBS) and marginal pulmonary function.ResultsOur initial attempts to use BiPAP in GBS and early neuromuscular respiratory failure were totally unsuccessful. There was marked initial improvement; however, emergency intubation was needed in both patients, one of which became acutely cyanotic.ConclusionsUntil more experience is available, we strongly warn against using BiPAP in deteriorating patients with GBS.

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