Respiratory Muscle Assessment in Acute Guillain-Barré Syndrome.

Area of Science:

• Neurology
• Pulmonology
• Critical Care Medicine

Background:

• Guillain-Barré Syndrome (GBS) is a critical neurological disorder characterized by progressive muscle weakness, often involving respiratory muscles, posing a life-threatening risk.
• Effective monitoring of respiratory muscle function is crucial for managing GBS patients in intensive care settings.

Purpose of the Study:

• To objectively evaluate the progression of respiratory muscle function in GBS patients during their initial week of intensive care unit (ICU) admission.
• To compare the efficacy of various respiratory muscle assessment tools in GBS.

Main Methods:

• Assessed Medical Research Council Sum Score (MRC-SS), vigorimetry, spirometry, and respiratory muscle strength (PImax/PEmax, Sniff Nasal Pressure - SnPna) twice daily.
• Evaluated GBS Disability Score (GBS-DS) daily, with blood gases and magnetic phrenic nerve stimulation (twitch mouth pressure - Pmo,tw) assessed on days 1 and 7.

Main Results:

• Nine GBS subjects were studied. MRC-SS, vigorimetry, PImax, and SnPna showed improvement from day 1 to day 7.
• GBS-DS, spirometry, and Pmo,tw remained unchanged.
• Sniff nasal pressure (SnPna) demonstrated a strong correlation with MRC-SS on both assessment days (r=0.77, p=0.02 on d1; r=0.74, p=0.02 on d7).

Conclusions:

• Sniff nasal pressure (SnPna) emerged as a reliable indicator of GBS severity, correlating significantly with clinical scores.
• Spirometry, a current standard, did not show a similar correlation, suggesting SnPna may be a superior tool for monitoring GBS respiratory function.