Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Spanish Society of Pediatric Intensive Care (SECIP) consensus recommendations for ECMO transport.

The evolution of extracorporeal membrane oxygenation treatment and the transport of patients receiving this treatment has changed dramatically in the last decade unevenly in different regions. The creation of specialized referral centers has been shown to improve outcomes. For all these reasons, it has been necessary to create networks of specialized teams and the number of secondary transports of patients with this treatment is increasing. In order to improve the quality of treatment and offer a guide to the services involved in these transports, the critical transport working groups of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Spanish Society of Pediatric Intensive Care (SECIP) have carried out a joint effort to prepare these recommendations, focused on the following aspects: indications, reference center systems, means of transport, characteristics and equipment, human teams, training and clinical safety.

Síndrome de Guillain-Barré: presentación clínica y evolución en menores de 6 años de edad / Guillain-Barré syndrome: clinical presentation and prognosis in children under six years-old

Introducción: El síndrome de Guillain-Barré (SGB) es una polineuropatía aguda de difícil diagnóstico en la primera infancia. Objetivos: Revisar la forma de presentación del SGB en niños menores de 6 años atendiendo al tiempo de evolución y sintomatología que presentaron hasta el diagnóstico, los hallazgos en las pruebas complementarias y la evolución y pronóstico. Pacientes y métodos: Revisamos a todos los pacientes menores de 6 años que cumplieran los criterios de Asbury et al para el diagnóstico de SGB. Resultados: Se incluyó a 8 pacientes, con una media de edad de 3,4 años. El 75% se registró la presencia de un agente infeccioso previo. La sintomatología previa al diagnóstico fue de carácter muy heterogéneo, lo que conllevó un amplio diagnóstico diferencial y multitud de exploraciones complementarias. El tiempo medio al diagnóstico fue de 8,5 días. El 100% presentó afectación motora de miembros inferiores, el 75% de miembros superiores y el 12% de musculatura respiratoria. La afectación sensitiva fue del 62,5% y la de pares craneales del 25%. Requirieron ingreso en cuidados intensivos un 25%. Se objetivó disociación albúmino-citológica en el líquido cefalorraquídeo (83,3%) y positividad de todos los estudios electrofisiológicos con distintos patrones. El pronóstico fue excelente en todos los pacientes. Conclusiones: El SGB en niños menores de 6 años es de difícil diagnóstico por la inespecificidad de las primeras manifestaciones en muchas ocasiones. Esto implica un amplio diagnóstico diferencial y retraso diagnóstico. Es relevante, el buen pronóstico en este grupo de edad de todos los subtipos electrofisiológicos(AU)

Introduction: Guillain-Barré syndrome (GBS) is an acute polyneuropathy that is difficult to diagnose in young children. Objectives: To review the form of presentation of GBS in children under six years-old at the time of onset and the symptoms they had until the diagnosis, the findings in the complementary tests, and the progression and prognosis. Patients and methods: All patients less than 6 years-old who fulfilled the Asbury et al criteria for the diagnosis of GBS were reviewed. Results: Eight patients with a mean age of 3.4years were included. Of those 75% recorded a previous infection. The symptoms prior to the diagnosis were very heterogeneous which entailed a wide differential diagnosis with many complementary examinations. The mean time to diagnosis was 8.5 days. All of them (100%) had motor involvement in the lower limbs, 75% in the upper limbs and 12% in the respiratory muscles. Sensory and cranial nerve involvement was observed in 62.5% and 25%, respectively. Admission to intensive care was required for 25% of the patients. Albumino-cytological dissociation was observed in the CSF in 83.3% and all the electrophysiological tests were positive with different patterns. The prognosis was excellent in all patients. Conclusions: GBS in children under 6 years-old is difficult to diagnosis due to the signs of onset often being unspecific. This entails a wide differential diagnosis, with the subsequent diagnostic delay. There is a good prognosis in all the electrophysiological sub-types in this age group(AU)

[Guillain-Barré syndrome: clinical presentation and prognosis in children under six years-old]. / Síndrome de Guillain-Barré: presentación clínica y evolución en menores de 6 años de edad.

INTRODUCTION: Guillain-Barré syndrome (GBS) is an acute polyneuropathy that is difficult to diagnose in young children. OBJECTIVES: To review the form of presentation of GBS in children under six years-old at the time of onset and the symptoms they had until the diagnosis, the findings in the complementary tests, and the progression and prognosis. PATIENTS AND METHODS: All patients less than 6 years-old who fulfilled the Asbury et al criteria for the diagnosis of GBS were reviewed. RESULTS: Eight patients with a mean age of 3.4 years were included. Of those 75% recorded a previous infection. The symptoms prior to the diagnosis were very heterogeneous which entailed a wide differential diagnosis with many complementary examinations. The mean time to diagnosis was 8.5 days. All of them (100%) had motor involvement in the lower limbs, 75% in the upper limbs and 12% in the respiratory muscles. Sensory and cranial nerve involvement was observed in 62.5% and 25%, respectively. Admission to intensive care was required for 25% of the patients. Albumino-cytological dissociation was observed in the CSF in 83.3% and all the electrophysiological tests were positive with different patterns. The prognosis was excellent in all patients. CONCLUSIONS: GBS in children under 6 years-old is difficult to diagnosis due to the signs of onset often being unspecific. This entails a wide differential diagnosis, with the subsequent diagnostic delay. There is a good prognosis in all the electrophysiological sub-types in this age group.