Comparative Analysis of Outcomes of Respiratory Failure Associated with Myasthenia Gravisversus Guillan-Barre Syndrome among Patients Admitted in Intensive Care Unit of Tertiary Care Hospital
Submission: 07 December 2025 | Acceptance: 02 February 2026 | Publication: 29 April March 2026
1Dr Umer Farooq, 2Dr Asif Hashmat, 3Dr Amber Gul, 4Dr Aida Younis, 5Dr Fawad Ahmad, 6Dr Qaisar Khan,
1Registrar Neurology, PEMH Rwp
2Professor of Medicine, PEMH Rwp
3Registrar Neurology, PEMH Rwp
4Registrar Neurology, PEMH Rwp
5Consultant Medical Specialist & Neurologist, PEMH Rwp
6District Surveillance Officer, DHO office, Lower Chitral KPK
ABSTRACT
Background: Recent research highlights the worldwide burden of these diseases. Respiratory failure due to MG usually follows exacerbations caused by infections or lack of compliance with medication, ICU stays for myasthenic crisis in 6-20% of patients with MG. A Saudi Arabian 2025 study documented that 68.3% of MG ICU admissions were for myasthenic crises, with 30% needing mechanical ventilation and 5% mortality, mostly in older patients as a result of sepsis and multiorgan failure.
Objectives: To compare the mean length of stay, complications, and mortality rates between MG and GBS patients admitted with respiratory failure.
Methods: This study will be a cross-sectional analytical design. The study will be conducted in the Department of Neurology at Pak Emirates Military Hospital, Rawalpindi, a tertiary care hospital. The study will span 3 months, commencing after approval from CPSP. The sample size will be calculated using a two-proportion formula to detect differences in moderate-to-severe disability at discharge (35.3% in MG vs. 83.2% in GBS) [3], with 80% power, alpha of 0.05, and a 1:1 allocation ratio, yielding approximately 15 patients per group. Accounting for a 20% attrition rate, the target sample size is 20 patients per group (total n=40), feasible based on the hospital’s admission rates. A non-probability consecutive sampling technique will be employed to enroll all eligible patients admitted during the study period.
Result: A total of 120 patients admitted to the intensive care unit (ICU) with respiratory failure were included in the study. Among them, 60 patients were diagnosed with Myasthenia Gravis (MG) and 60 with Guillain-Barré Syndrome (GBS).
5. Conclusion
Respiratory failure associated with Guillain-Barré Syndrome is linked to more severe clinical outcomes compared to Myasthenia Gravis, including longer duration of mechanical ventilation, extended ICU stay, and higher complication rates. Although mortality differences were not statistically significant, the overall disease burden is greater in GBS patients. Early diagnosis, prompt initiation of supportive care, and vigilant monitoring for complications are essential to improve outcomes. Tailored management strategies should be implemented for each condition, with particular attention to the prolonged recovery phase in GBS patients.
Keywords: Myasthenia Gravis, Respiratory Failure, Intensive Care Unit, Guillan-Barre Syndrome