Intensive care management of Guillain-Barre syndrome: A retrospective outcome study and review of literature

Abstract

Abstract Introduction: Guillain-Barre syndrome (GBS) is an immune mediated disorder which is associated with demyelination of peripheral nervous system and progressive muscle weakness. Severely affected patients have respiratory dysfunction and may need ventilatory support which can cause significant morbidity and mortality. There is limited Indian data with regards to the outcome of severely affected GBS patients. The present study reflects the intensive care management of severely affected GBS patients at neurological centre of a tertiary care institute of India. Materials and Methods: The study was designed to retrospectively review the patient records who were admitted to neurological intensive care unit (ICU) of AIIMS, New Delhi. The epidemiology, clinical features, course of management and outcome of GBS patients admitted between April 2000 to December 2005 were recorded and analysed. Results: The data of 59 patients were available for inclusion in the study. The mean age of patients admitted to neurological ICU was 35 years with male preponderance. Ventilatory failure was the most common indication for ICU admission. 95% patients required ventilatory support for a mean duration of 30 days. The mortality data included 60 patients and 13 patients died during the course of management. Conclusions: The present study indicates that severely affected GBS patients may need prolonged mechanical ventilation. Despite management in a specialized neurological ICU the mortality can be as high as 21%.