Symptomatic Treatment:
-
Respiratory distress (15-30% require intubation)
NIF/VC BID (intubation may be required if NIF <30cmH2O, VC <20ml/kg, or 60% of expected normal VC)
Monitor for bulbar weakness, difficulty swallowing
Autonomic dysfunction: do not treat unless necessary due to rebound
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Severe hypotension: fluids, short acting pressor i.e. phenylephrine
- Severe hypertension/MAP > 150 (less common than hypotension): nitro, labetalol, esmolol
Neuropathic pain (develops in 15% of pts): NSAIDS, gabapentin, carbamazepine, morphine
Note that immunizations are NOT recommended during the acute phase of GBS and are not suggested for a period of one year or more after the onset of GBS