Nursing Care for Patients with Guillain-Barré Syndrome Requiring Mechanical Ventilation during the Rehabilitation Phase and Continuous Home Care: A Comparative Case Study of Two Cases

Abstract

Guillain-Barré syndrome (GBS) is an immune-mediated disorder affecting the peripheral nervous system, resulting in progressive muscle weakness that may advance to paralysis and, in severe cases, respiratory failure requiring mechanical ventilation. Nursing care for patients with GBS who remain ventilator-dependent during the rehabilitation phase and continuing home care is therefore crucial for recovery and quality of life. This study aimed to compare nursing care in two patients with GBS requiring mechanical ventilation during rehabilitation and continuing home care. A comparative case study design was used. Data were collected from medical records and direct observation, and were analyzed by comparing pathophysiology, risk factors, clinical manifestations, treatment, and nursing diagnoses. The findings showed that Case 1 was a 48-year-old Thai man diagnosed with GBS with respiratory failure, whereas Case 2 was a 36-year-old Thai woman diagnosed with septic shock with acute respiratory distress syndrome (ARDS) and GBS. Although both patients had similar underlying pathophysiology, Case 2 was more severe and clinically complex because of concomitant ARDS and septic shock, which increased the complexity of respiratory management and rehabilitation. Nursing care in both cases focused on three phases: the acute phase, the rehabilitation phase, and the rehabilitation phase with continuing home care, particularly respiratory care, tracheostomy care, functional rehabilitation, and caregiver preparation before discharge. In conclusion, continuing home care is a key component of nursing care for ventilator-dependent patients with GBS. Caregiver preparation, ongoing rehabilitation, and regular home visits can help reduce complications and promote effective recovery.