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Published on: November 9, 2017
[Guillain-Barré syndrome in the critical care unit in the last 10 years]
M Uribarri López1, L Aguilera Celorrio, C Miguel Martínez
1Servicio de Anestesia-Reanimación, Hospital de Basurto, Bilbao, Bizkaia, España. mariuri@gmail.com
Objectives:
The Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy, which constitutes an important proportion of acute flaccid paralysis cases. Our objective was to present the clinical characteristics of patients with the GBS who required admission to a critical care unit.
Methods:
A retrospective study over a period of ten years was conducted on patients with GBS, who were admitted to the critical care unit in a tertiary hospital. The proportion of patients requiring connection to mechanical ventilation (MV) and associated complications was analysed, along with certain clinical features which implied a more severe illness and worse functional recovery.
Results:
MV was required in 58.8% of cases (mean duration 29.8 days). Nine patients received tracheostomy. Pulmonary complications were observed in all patients that needed MV (50% tracheobronchitis and 50% ventilator-associated pneumonia). MV is associated with pulmonary complications (P=.001) and those, in turn, to the development of sepsis (P=.006). Only one patient died (5.88%). No relationship was found between advanced age, MV, comorbidity, sepsis, or hemodynamic complications and the mortality of GBS.
Conclusions:
Death in these patients results from pulmonary complications, sepsis and less frequently due to autonomic dysfunction or pulmonary embolism. Emphasising the importance of their prevention, detection and management.
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