A vital parameter? Systematic review of spirometry in evaluation for intensive care unit admission and intubation and ventilation for Guillain-Barré syndrome

Reema Madike, Thomas Muecke, Noel Dishnica, Linyi Zhu, Sheryn Tan, Joshua Kovoor, Brandon Stretton, Aashray Gupta, Adil Harroud, Andrew Bersten, David Schultz, Stephen Bacchi

Research output: Contribution to journalReview articlepeer-review

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Abstract

Background: Patients with Guillain-Barré syndrome (GBS) may require intensive care unit (ICU) admission for intubation and ventilation (I + V). The means to predict which patients will require I + V include spirometry measures. The aims of this study were to determine, for adult patients with GBS, how effectively different spirometry parameter thresholds predict the need for ICU admission and the requirement for I + V; and what effects these different parameter thresholds have on GBS patient outcomes. 

Method: A systematic review was conducted of the databases PubMed, EMBASE, and Cochrane library in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic review was registered prospectively on PROSPERO. 

Results: Initial searches returned 1011 results, of which 8 fulfilled inclusion criteria. All included studies were observational in nature. Multiple studies suggest that a vital capacity below 60% of predicted value on admission is associated with the need for eventual I + V. No included studies evaluated peak expiratory flow rate, or interventions with different thresholds for ICU or I + V. 

Conclusions: There is a relationship between vital capacity and the need for I + V. However, there is limited evidence supporting specific thresholds for I + V. In addition to evaluating these factors, future research may evaluate the effect of different patient characteristics, including clinical presentation, weight, age, and respiratory comorbidities, on the effectiveness of spirometry parameters in the prediction of the need for I + V.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalJournal of Clinical Neuroscience
Volume113
Early online date3 May 2023
DOIs
Publication statusPublished - Jul 2023

Keywords

  • Bedside
  • Critical care
  • Forced vital capacity
  • Peak expiratory flow rate
  • Respiratory failure
  • Respiratory function

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