Clinical Features Associated With Need for Mechanical Ventilation in Children With Guillain-Barré Syndrome: Retrospective Cohort From India

Randhawa, Manjinder Singh; Iyer, Rajalakshmi; Bansal, Arun; Mukund, Bal; Angurana, Suresh Kumar; Nallasamy, Karthi; Jayashree, Muralidharan; Singhi, Sunit; Singhi, Pratibha; Baranwal, Arun; Sankhyan, Naveen

doi:10.1097/pcc.0000000000002930

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Similar to adult cohorts, requirement for mechanical ventilation in pediatric patients has been associated with facial weakness, cranial nerve involvement, more severe muscle weakness, time from symptom onset to admission, axonal variant GBS, and dysautonomia. 32 56 57 Reported prognosis was not as favorable in a study of a pediatric cohort from India. In this study of outcomes at 3 months, 2% died, 47% had complete recovery, and 24% had poor recovery (requiring wheelchair).…”

Section: Prognosis In Pediatric Populationsmentioning

confidence: 99%

“…The validity of the EGRIS to predict the need for mechanical ventilation has been further confirmed in several patient cohorts internationally. 31 32 An online calculator for calculating the EGRIS is available through the website of the International GBS Outcome Study (IGOS) group ( …”

Section: Predicting Need For Mechanical Ventilationmentioning

confidence: 99%

“…Similar to adult cohorts, requirement for mechanical ventilation in pediatric patients has been associated with facial weakness, cranial nerve involvement, more severe muscle weakness, time from symptom onset to admission, axonal variant GBS, and dysautonomia. 32,56,57 Reported prognosis was not as favorable in a study of a pediatric cohort from Abbreviations: EGOS, Erasmus Guillain-Barre Syndrome Outcome Score; GBS, Guillain-Barre syndrome. Predictions corresponding to these prognostic scores range from 1 to 52% for the inability to walk independently at 6 months.…”

Section: Prognosis In Pediatric Populationsmentioning

confidence: 99%

“…Thieme. All rights reserved.Guillain-Barré Syndrome Traub, Chaudhry 79331,32 An online calculator for calculating the EGRIS is available through the website of the International GBS Outcome Study (IGOS) group (https://gbstools.erasmusmc.nl/prognosis-tool).…”

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confidence: 99%

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Neuroprognostication: Guillain–Barré Syndrome

Traub,

Chaudhry

2023

Semin Neurol

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Guillain–Barré syndrome is an immune-mediated disease of the peripheral nerves characterized by rapidly progressing symmetric weakness, areflexia, and albuminocytological dissociation. Most patients reach their nadir within 2 weeks. Disease severity can be mild to severe, with 20% of patients requiring mechanical ventilation. Intravenous immunoglobulin and plasma exchange are equally effective treatments. Monitoring strength, respiratory function, blood pressure, and heart rate, as well as pain management and rehabilitative therapy are important aspects of management. About 20% of patients require assistance to walk at 6 months. Older age, preceding diarrhea, and lower Medical Research Council (MRC) sum scores predict poor outcome. Death from cardiovascular and respiratory complications can occur in the acute or recovery phases of the illness in 3 to 7% of the patients. Risk factors for mortality include advanced age and disease severity at onset. Neuropathic pain, weakness, and fatigue can be residual symptoms; risk factors for these include axonal loss, sensory involvement, and severity of illness.

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Section: Prognosis In Pediatric Populationsmentioning

confidence: 99%

Section: Predicting Need For Mechanical Ventilationmentioning

confidence: 99%

“…Similar to adult cohorts, requirement for mechanical ventilation in pediatric patients has been associated with facial weakness, cranial nerve involvement, more severe muscle weakness, time from symptom onset to admission, axonal variant GBS, and dysautonomia. 32,56,57 Reported prognosis was not as favorable in a study of a pediatric cohort from Abbreviations: EGOS, Erasmus Guillain-Barre Syndrome Outcome Score; GBS, Guillain-Barre syndrome. Predictions corresponding to these prognostic scores range from 1 to 52% for the inability to walk independently at 6 months.…”

Section: Prognosis In Pediatric Populationsmentioning

confidence: 99%

mentioning

confidence: 99%

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Neuroprognostication: Guillain–Barré Syndrome

Traub,

Chaudhry

2023

Semin Neurol

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“…Rapid progression of symptoms, bulbar involvement, autonomic dysfunction, severe weakness with inability to walk, and impaired neck flexion predict the need for ventilation in pediatric GBS. 89,94,95 Importantly, a multidisciplinary discussion involving pediatric specialists from critical care medicine, neurology, anesthesia, and neuroradiology should take place before any procedural sedation, as this may be a high-risk situation for decompensation. For MRI, optimizing sequence selection, using nonpharmacological distraction techniques, and discussing a sedation plan that favors the use of short-acting agents under close monitoring are essential.…”

Section: General Consideration In Acute Weakness Of Suspected Neuroim...mentioning

confidence: 99%

Update in Pediatric Neurocritical Care: What a Neurologist Caring for Critically Ill Children Needs to Know

Plante,

Basu,

Gettings

et al. 2024

Semin Neurol

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Currently nearly one-quarter of admissions to pediatric intensive care units (PICUs) worldwide are for neurocritical care diagnoses that are associated with significant morbidity and mortality. Pediatric neurocritical care is a rapidly evolving field with unique challenges due to not only age-related responses to primary neurologic insults and their treatments but also the rarity of pediatric neurocritical care conditions at any given institution. The structure of pediatric neurocritical care services therefore is most commonly a collaborative model where critical care medicine physicians coordinate care and are supported by a multidisciplinary team of pediatric subspecialists, including neurologists. While pediatric neurocritical care lies at the intersection between critical care and the neurosciences, this narrative review focuses on the most common clinical scenarios encountered by pediatric neurologists as consultants in the PICU and synthesizes the recent evidence, best practices, and ongoing research in these cases. We provide an in-depth review of (1) the evaluation and management of abnormal movements (seizures/status epilepticus and status dystonicus); (2) acute weakness and paralysis (focusing on pediatric stroke and select pediatric neuroimmune conditions); (3) neuromonitoring modalities using a pathophysiology-driven approach; (4) neuroprotective strategies for which there is evidence (e.g., pediatric severe traumatic brain injury, post–cardiac arrest care, and ischemic stroke and hemorrhagic stroke); and (5) best practices for neuroprognostication in pediatric traumatic brain injury, cardiac arrest, and disorders of consciousness, with highlights of the 2023 updates on Brain Death/Death by Neurological Criteria. Our review of the current state of pediatric neurocritical care from the viewpoint of what a pediatric neurologist in the PICU needs to know is intended to improve knowledge for providers at the bedside with the goal of better patient care and outcomes.

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Clinical characteristics and functional outcomes of pediatric Guillain-Barré syndrome admitted to the Neuro-intensive care unit: a decade-long retrospective observational study

Surve,

Sharma,

Nisal

et al. 2024

Neurol Sci

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Clinical Features Associated With Need for Mechanical Ventilation in Children With Guillain-Barré Syndrome: Retrospective Cohort From India

Abstract: To analyze the clinical features associated with the need for mechanical ventilation (MV) in children with Guillain-Barré syndrome (GBS).

Cited by 6 publications

References 19 publications

Neuroprognostication: Guillain–Barré Syndrome

Neuroprognostication: Guillain–Barré Syndrome

Update in Pediatric Neurocritical Care: What a Neurologist Caring for Critically Ill Children Needs to Know

Clinical characteristics and functional outcomes of pediatric Guillain-Barré syndrome admitted to the Neuro-intensive care unit: a decade-long retrospective observational study

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