El síndrome de Guillain Barré en la unidad de cuidados críticos en los últimos 10 años / Guillain-Barré syndrome in the critical care unit in the last 10 years

Objetivos. El síndrome de Guillain Barré (SGB) es una polirradiculoneuropatía inflamatoria aguda que constituye una proporción importante de los casos de parálisis flácida aguda. Nuestro objetivo es presentar las características clínicas de los pacientes con diagnóstico de este síndrome que requirieron ingreso en la unidad de cuidados críticos. Métodos. Estudio retrospectivo de los pacientes con SGB que fueron admitidos en la unidad de cuidados críticos de un hospital terciario durante un periodo de 10 años. Se estudia la proporción de pacientes que requirieron ventilación mecánica invasiva (VMI) y las complicaciones asociadas. Se analizan características clínicas que implican mayor severidad de la enfermedad y una recuperación funcional peor. Resultados. La VMI fue necesaria en el 58,8% de los pacientes (duración media de 29,8 días). A 9 se les realizó traqueostomía. Se observaron complicaciones respiratorias en todos los casos que precisaron VMI (50% traqueobronquitis y 50% neumonía asociada a ventilación mecánica). La VMI se asoció a complicaciones respiratorias (p=0,001) y estas a su vez a la aparición de sepsis (p=0,006). Falleció un paciente (5,88%). No se observó asociación entre edad avanzada, necesidad de VMI, presencia de comorbilidad, sepsis o complicaciones hemodinámicas con la mortalidad del SGB. Conclusiones. Las complicaciones respiratorias, la sepsis y en menor medida la disfunción autonómica y el tromboembolismo pulmonar son las principales causas de muerte en estos pacientes, por lo que su prevención, detección y manejo son fundamentales(AU)

Objectives. The Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy, which constitutes an important proportion of acute flaccid paralysis cases. Our objective was to present the clinical characteristics of patients with the GBS who required admission to a critical care unit. Methods. A retrospective study over a period of ten years was conducted on patients with GBS, who were admitted to the critical care unit in a tertiary hospital. The proportion of patients requiring connection to mechanical ventilation (MV) and associated complications was analysed, along with certain clinical features which implied a more severe illness and worse functional recovery. Results. MV was required in 58.8% of cases (mean duration 29.8 days). Nine patients received tracheostomy. Pulmonary complications were observed in all patients that needed MV (50% tracheobronchitis and 50% ventilator-associated pneumonia). MV is associated with pulmonary complications (P=.001) and those, in turn, to the development of sepsis (P=.006). Only one patient died (5.88%). No relationship was found between advanced age, MV, comorbidity, sepsis, or hemodynamic complications and the mortality of GBS. Conclusions. Death in these patients results from pulmonary complications, sepsis and less frequently due to autonomic dysfunction or pulmonary embolism. Emphasising the importance of their prevention, detection and management(AU)

[Guillain-Barré syndrome in the critical care unit in the last 10 years]. / El síndrome de Guillain Barré en la unidad de cuidados críticos en los últimos 10 años.

OBJECTIVES: The Guillain-Barré syndrome (GBS) is an acute inflammatory polyradiculoneuropathy, which constitutes an important proportion of acute flaccid paralysis cases. Our objective was to present the clinical characteristics of patients with the GBS who required admission to a critical care unit. METHODS: A retrospective study over a period of ten years was conducted on patients with GBS, who were admitted to the critical care unit in a tertiary hospital. The proportion of patients requiring connection to mechanical ventilation (MV) and associated complications was analysed, along with certain clinical features which implied a more severe illness and worse functional recovery. RESULTS: MV was required in 58.8% of cases (mean duration 29.8 days). Nine patients received tracheostomy. Pulmonary complications were observed in all patients that needed MV (50% tracheobronchitis and 50% ventilator-associated pneumonia). MV is associated with pulmonary complications (P=.001) and those, in turn, to the development of sepsis (P=.006). Only one patient died (5.88%). No relationship was found between advanced age, MV, comorbidity, sepsis, or hemodynamic complications and the mortality of GBS. CONCLUSIONS: Death in these patients results from pulmonary complications, sepsis and less frequently due to autonomic dysfunction or pulmonary embolism. Emphasising the importance of their prevention, detection and management.