• Syed Mushtaq Gilani


An early ventilator or respiratory' assistor wasinvented by Janeway1 in 1913. Crafoord-a thoracicsurgeon reported on his “Spiropulsator” along withAnderson2 launching the ventilator for intermittentpositive pressure ventilation (IPPV)in the intensivetherapy unit. Under the guidance of Prof. Macintoshand his department at oxford anaesthetists becameclinicians who best understood the ventilation and sobegan the anaesthetist’s involvement in ICU.Guillaine-Barre syndrome, noted first by Landy in1859 and subsequently by Guillain, Barre and Strohlin 1916, may best be described as an AcuteInflammatory' Polyradiculoneuropathy 3 with aprevalence of approximately. 1.5 per 100,000 ofpopulation. It may affect individuals of any age4. Thedisease is self-limiting, the main life threateningproblem in AIP is acute respiratory- failure resultingfrom respiratory' muscle weakness and may needartificial ventilation.What follows is our experience of mechanicalventilation of two cases of AIP (Guillain- Barresyndrome) in the ICU of SK Institute of MedicalSciences, Srinagar (Kashmir).


Janeway HH. “Intra Tracheal anaesthesia”, Ann Surg .1913,


Anderson S, Crafoord C, Freehner P “A new and practical

method of producing rythmic ventilation during positive

pressure anaesthesia with description of the apparatus” Acta

Otolaryngnol scand 1940,28: 95

Hughes RA “Acute Inflammatory polyneuropathy” Br. J.

Hosp Med 1978,20: 688

Lesser RP. Hauser WA. Kurland LT & Mulder DW

“Epidemiologic features of Guillain-Barre syndrome,

experience in Olmsted County, Minnesoto” Neurology 1973,


Asbury AK, Amason BGW, Karp HR & McFarllin DE.

“Criteria for diagnosis of Guillain-Barre syndrome”. Ann.

Neurol. 1978,2: 565

Hughes RA, Newson-Davis J, Perkin JM. “Controlled trial of

prednisolone in acute polyneuropathy”. Lancet. 1978, 2: 750

Parker MM, Shubert W, Shelhamer JH et, al.’’Perceptions of

a critically ill patient experiencing therapeutic paralysis in an

ICU.” CritCare Med. 1984, 12: 69-71

Loh L. “Neurological and neuromuscular disease.” Br. J.

Anaesth. 1986,58: 190-20