{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T11:06:58Z","timestamp":1779016018738,"version":"3.51.4"},"reference-count":7,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":131,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Guillain\u2013Barr\u00e9 syndrome (GBS) is a major cause of neuromuscular respiratory failure globally. In many low\u2010income settings, access to mechanical ventilation and disease\u2010modifying therapy is limited. We describe the management of a young woman with rapidly progressive GBS and bulbar weakness in a mission hospital in northern Madagascar without access to intensive care facilities, invasive ventilation or immunotherapy. Respiratory failure was managed using a structured high\u2010dependencyunit (HDU) framework combining noninvasive respiratory support with intensive nursing care, physiotherapy, regular repositioning and close nurse\u2010led observation. The patient survived the acute phase, regained swallow and speech by Day 8 and was discharged from HDU on Day 15. At 1\u2010year follow\u2010up, she had recovered full upper limb strength with residual lower limb weakness. This case highlights the potential for structured supportive care in an HDU to sustain life in clinically significant neuromuscular respiratory failure when definitive critical care resources are unavailable.<\/jats:p>","DOI":"10.1155\/crcc\/1700879","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T10:41:01Z","timestamp":1778582461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Dependency Care Without Mechanical Ventilation for Severe Guillain\u2013Barr\u00e9 Syndrome in a Rural Low\u2010Income Setting"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9715-1467","authenticated-orcid":false,"given":"Lesley","family":"Notghi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Little","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-4392","authenticated-orcid":false,"given":"Joel","family":"Chin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0250-9"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00339-1"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21976"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fresc.2023.1164628"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jns.12189"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1484661"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2008.02202.x"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crcc\/1700879","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crcc\/1700879","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crcc\/1700879","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T10:40:57Z","timestamp":1779014457000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crcc\/1700879"}},"subtitle":[],"editor":[{"given":"Chiara","family":"Lazzeri","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crcc\/1700879"],"URL":"https:\/\/doi.org\/10.1155\/crcc\/1700879","archive":["Portico"],"relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"value":"2090-6420","type":"print"},{"value":"2090-6439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1700879"}}