Document Detail


The morbidity and outcome of patients with Guillain-Barré syndrome admitted to the intensive care unit.
MedLine Citation:
PMID:  17881005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
One third of patients with Guillain-Barré syndrome (GBS) require admission to the intensive care unit (ICU), associated with significant risk of morbidity, mortality, and incomplete recovery. METHODS: 76 adult patients with GBS admitted to the ICU at a regional referral center over a 20-year period were studied. We determined the frequency, nature, and predictors of complications they experienced while in the ICU; this morbidity was related to long-term functional recovery and time to regain independent ambulation, extracted from longitudinal follow-up data. RESULTS: ICU stay was a median 21 days and mechanical ventilation (MV) was required in 78% (median duration 28 days). Two-thirds suffered at least one major complication, most commonly pneumonia (54%). Morbidity was strongly associated with MV and male sex. Mortality occurred in only 5 patients (6.5%). Over an average 3 years follow-up, recovery of independent ambulation was seen in 75%, with advanced age being the most powerful predictor of poor outcome. Prolonged MV and severe axonal loss did not preclude a favorable recovery. Time to ambulate was a median 198 days, although recovery could occur as late as ten years after onset; slower recovery was associated with ICU complications, prolonged MV, and early axonal abnormalities. CONCLUSION: Although patients with GBS suffer significant morbidity during protracted ICU stays, with meticulous supportive care, many make gratifying functional recoveries. In severely afflicted patients, this may only be appreciated after extended follow-up.
Authors:
Rajat Dhar; Larry Stitt; Angelika F Hahn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-18
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  264     ISSN:  0022-510X     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-07     Completed Date:  2008-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  121-8     Citation Subset:  IM    
Affiliation:
Neurology/Neurosurgery Intensive Care Unit, Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri 63110, United States. dharr@neuro.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Female
Follow-Up Studies
Guillain-Barre Syndrome / mortality*,  nursing
Humans
Intensive Care Units / statistics & numerical data*
Length of Stay / statistics & numerical data
Male
Middle Aged
Peripheral Nerves / pathology,  physiopathology
Pneumonia / mortality,  nursing
Recovery of Function / physiology
Respiration, Artificial / statistics & numerical data
Retrospective Studies
Sex Distribution
Time Factors
Wallerian Degeneration / etiology,  pathology,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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