Intubation & Ventilation Scenario 2

A 47 year old male with a two week history of upper respiratory tract infection is admitted with a history of bilateral lower limb weakness and shortness of breath. His forced vital capacity is 1 liter and his pCO2 is 70mmHg and pO2 60mmHg.

Solution

This patient has ventilatory failure, as evidenced by his inability to clear carbon dioxide. His diagnosis turns out to be Guillain-Barre syndrome, which is characterized by motor, sensory and autonomic neural demyelination and thus neuropathy, which usually eventually reverses. The low FVC is a sign of poor physiological reserve, and this patient requires controlled mechanical ventilation.