A Predictive Model for Respiratory Failure and Determining the Risk Factors of Prolonged Mechanical Ventilation in Children with Guillain-Barre Syndrome

Objective: Determining the predictors of respiratory failure and duration of intubation in children with Guillain-Barre syndrome (GBS).

Materials & Methods: Children diagnosed with GBS at Tabriz Children's Hospital were studied. Factors associated with and influencing respiratory failure as well as the duration of intubation were determined using both univariate and multiple analyses.

Results: Overall, 324 children were enrolled in the study, 54.0% of whom were males. Thirty-one (9.6%) patients underwent mechanical ventilation, the patients under 5 years old were more prone to the requirement of mechanical ventilation (11.3% vs. 6.9%). Cases hospitalized in winter were more likely to need ventilation compared to those hospitalized in spring (OR =7.00; 95% CI:1.51-32.53). Also, autonomic involvement (OR=8.88, 95% CI:4.03-19.58; p<0.001) and cranial nerves involvement (OR=9.88, 95% CI:3.68 - 26.52; p<0.001) emerged as risk factors for mechanical ventilation requirement. Overall, 16.1% of patients with axonal electrophysiologic pattern required mechanical ventilation compared to 7.4% of those with demyelinating type (OR:2.15, 95% CI: 1.01-4.69). In univariate analysis, the only variable that showed a correlation with the duration of intubation was axonal electrophysiologic pattern (p= 0.028).

Conclusion: Approximately, 10% of the patients required mechanical ventilation. Season, cranial nerve involvement, autonomic dysfunction and electrophysiologic pattern were the most important variables in predicting respiratory failure and duration of mechanical ventilation.