{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:16:06Z","timestamp":1771683366653,"version":"3.50.1"},"reference-count":5,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP20K19304"],"award-info":[{"award-number":["JP20K19304"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Mechanical insufflation\u2010exsufflation (MI\u2010E) is an effective airway clearance device for impaired cough associated with respiratory muscle weakness caused by neuromuscular disease. Its complications on the respiratory system, such as pneumothorax, are well\u2010recognized, but the association of the autonomic nervous system dysfunction with MI\u2010E has never been reported. We herein describe two cases of Guillain\u2013Barr\u00e9 syndrome with cardiovascular autonomic dysfunction during MI\u2010E: a 22\u2010year\u2010old man who developed transient asystole and an 83\u2010year\u2010old man who presented with prominent fluctuation of blood pressure. These episodes occurred during the use of MI\u2010E with abnormal cardiac autonomic testing, such as heart rate variability in both patients. While Guillain\u2013Barr\u00e9 syndrome itself may cause cardiac autonomic dysfunction, MI\u2010E possibly caused or enhanced the autonomic dysfunction by an alternation of thoracic cavity pressure. The possibility of MI\u2010E\u2010related cardiovascular complications should be recognized, and its appropriate monitoring and management are necessary, particularly when used for Guillain\u2013Barr\u00e9 syndrome patients.<\/jats:p>","DOI":"10.1002\/rcr2.1135","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T08:50:08Z","timestamp":1681375808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiovascular autonomic dysfunction induced by mechanical insufflation\u2010exsufflation in <scp>Guillain\u2013Barr\u00e9<\/scp> syndrome"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0062-7949","authenticated-orcid":false,"given":"Ryota","family":"Kuroiwa","sequence":"first","affiliation":[{"name":"Division of Rehabilitation Medicine Chiba University Hospital  Chiba Japan"},{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihisa","family":"Tateishi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Chiba Kaihin Municipal Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taku","family":"Oshima","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumoto","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Medicine Chiba University Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astushi","family":"Murata","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Medicine Chiba University Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00517-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/rcr2.447"},{"issue":"2","key":"e_1_2_10_4_1","first-page":"93","article-title":"Cardiovascular complications and its relationship with functional outcomes in Guillain\u2010Barre syndrome","volume":"113","author":"Gupta S","year":"2020","journal-title":"QJM"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1990.00530060120029"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-018-0525-z"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.1135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T08:39:03Z","timestamp":1692693543000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.1135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":5,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1002\/rcr2.1135"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.1135","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]},"assertion":[{"value":"2023-03-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01135"}}