Outcome of Guillain-Barre Syndrome in DMCH ICU - A 5 Years Experience

Abstract

Guillain - Barre Syndrome (GBS) is the commonest peripheral neuropathy causing ventilatory failure. In this study, all the patients clinically diagnosed as a case of Guillain - Barre Syndrome (GBS) admitted in DMCH between January 2002 to December 2006, were analysed to evaluate the prognostic value and to understand the morbidity and mortality associated with ICU care. Total 406 patients were admitted in DMCH in last 5 years, of which 167 (41.13%) needed ICU care, which was about 10.01% of total ICU admission. 112 patients (67.07%) improved and leave ICU with or without some residual effects like weakness of both legs, persistent tracheostomy, malnutrition etc. and 55 patients (32.93%) were expired. The age of the subjects treated in ICU were 0-10 years 28(16.76%), 11-20 years 49 (29.34%), 21- 30 years 38 (22.75%), 31-40 years 24 (14.37%), 41-50 years 18 (10.77%) and 50 years and above 13 (7.78%). The duration of ICU stay were 0-10 days 88 (55.69%), 11-20 days 22 (13.17%), 21-30 days 12 (7.18%), 31- 40 days 6 (3.59%), 41-50 days 9 (5.38%) and > 50days 30 (17.96%). 39 patients (23.35%) needed tracheostomy. 77 patients (46.10%) needed mechanical ventilation. The median duration of mechanical ventilation was 35 days. The patients were ventilated more than 30 days usually developed ventilator - associated pneumonia and / or sepsis, malnutrition etc. Complications were uncommon if ICU stay were less than 3 weeks. Only 4 patients had history of readmission for second attack between this period. Only 7 patients were treated with immunotherapy which did not produce significant extra benefit. No patient was managed with plasma exchange (PE).

Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.9-13