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The combination of multiple clinical factors culminates in neuromuscular respiratory failure in up to 30% of the patients with Guillain-Barré syndrome (GBS). Although guidelines exist as to when to proceed with intubation, early indicators of subsequent progression to respiratory failure have not been established.

To identify clinical and respiratory features associated with progression to respiratory failure and to examine patterns of respiratory decline in patients with severe GBS.

Retrospective survey.

Tertiary care hospital.

One hundred fourteen consecutive patients with severe GBS admitted to the intensive care unit between January 1, 1976, and December 31, 1996.

Early markers of impending respiratory failure, requirement for mechanical ventilation, and patterns of respiratory decline.

The clinical and electrophysiologic features of 60 patients …