Predictors of respiratory failure in patients with Guillain–Barré syndrome: a systematic review and meta‐analysis

Green, Cameron; Baker, Tess; Subramaniam, Ashwin

doi:10.5694/mja17.00552

Cited by 48 publications

(44 citation statements)

References 37 publications

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“…Potential predictors of MV requirement in patients with GBS have been explored in several studies. These variables include an interval from symptom onset to admission shorter than seven days, shorter time duration between symptom onset and peak disability, inability to lift one's head from the bed, vital capacity less than 60% of the predicted value, tongue weakness, presence of anti‐ganglioside Q1b antibodies, along with the presence of facial and bulbar weakness, severe muscle weakness at hospital admission, single breath counting, disease occurrence in summer, and glossopharyngeal and vagus nerve involvement (GVND) 5‐11 . In most previous studies, potential associations of clinicodemographic characteristics with MV have been explored using bivariate analyses.…”

Section: Introductionmentioning

confidence: 99%

A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

Ning

Yang

et al. 2020

Acta Neurol Scand

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Guillain-Barré syndrome (GBS) is the most common acute paralytic neuropathy, characterized by symmetrical weakness of the limbs and hyporeflexia or areflexia. GBS usually occurs after an infection, with two-thirds of GBS patients having a history of respiratory or gastrointestinal infection before GBS onset. 1 During the progressive phase, 20%-30% of patients need mechanical ventilation (MV) in an intensive care unit (ICU) because of respiratory failure, which can worsen functional outcomes and even lead to death. 2-4 Therefore, it is very important to find early predictors of MV in patients with GBS.

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Section: Introductionmentioning

confidence: 99%

A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

Ning

Yang

et al. 2020

Acta Neurol Scand

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“…We compared the following covariates between the early and non-early tracheostomy groups: age [30]; sex; body mass index (kg/m 2 ); Japan Coma Scale status at admission [31]; Charlson comorbidity index score [2,4,32]; chronic pulmonary disease as a comorbidity at admission [5,7]; pneumonia (ICD-10 code J10-J18 or J69) as a complication at admission [6]; hyponatremia (ICD-10 codes E222 and E871) as a complication at admission [33,34]; neurological presentation at admission (bulbar palsy [ICD-10 codes G12, G521, G522, G523, R13, and R47] and autonomic dysfunction [ICD-10 codes G90, H570, I10, I49, I95, K56, K59, L74, N39, R00, R15, R32, R33, R39, and R61]) [35,36]; ambulance use; referral from other hospitals; treatment year [1][2][3][4]; number of days from hospital admission to MV initiation [6]; ICU admission until the day of MV initiation; treatments until the day of MV initiation [procedures and monitoring (invasive arterial pressure monitoring, central venous catheter insertion, CO 2 monitoring, deep vein thrombosis prophylaxis, and chest compression and/or defibrillation), medical treatments (vasopressors, intravenous antihypertensive drugs, antiarrhythmic drugs, insulin, antiulcer drugs, antibiotic drugs, heparin, and enteral nutrition), and starting immunotherapy (plasma exchange, intravenous immunoglobulin (IVIg), intravenous corticosteroids, and none)].…”

Section: Covariates and Outcomesmentioning

confidence: 99%

Effect of Early Tracheostomy on Mortality of Mechanically Ventilated Patients with Guillain–Barré Syndrome: A Nationwide Observational Study

Yonezawa

Matsui

et al. 2020

Neurocrit Care

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Background: Patients with Guillain-Barré syndrome (GBS) who require mechanical ventilation (MV) are regarded as candidates for early tracheostomy because of the high risk of prolonged MV; however, the association between early tracheostomy and favorable outcomes in patients with GBS remains unclear. In this study, we evaluated the association between early tracheostomy and outcomes in mechanically ventilated patients with GBS.Methods: This retrospective observational study included adult patients with GBS identified in the Japanese Diagnosis Procedure Combination national inpatient database from July 1, 2010, to March 31, 2018, who initiated MV within the first week of admission and who received MV for more than 1 week. Early tracheostomy was defined as tracheostomy performed within 7 days of MV. The primary outcome was in-hospital mortality, and the secondary outcomes were 28-day mortality, nosocomial pneumonia, length of hospital stay, length of intensive care unit (ICU) stay, duration of MV, duration of sedation, duration of analgesia, duration of delirium, and total hospitalization costs. Propensity scores for early tracheostomy were calculated using a logistic regression model on the following variables: age; sex; body mass index; Japan Coma Scale status at admission; Charlson comorbidity index score; comorbidity of chronic pulmonary disease; complication of pneumonia at admission; complication of hyponatremia at admission; neurological presentation at admission; ambulance use; referral from other hospitals; treatment year; days from hospital admission to MV initiation; ICU admission until the day of MV initiation; and treatments until the day of MV initiation. Stabilized inverse probability of treatment weighting analyses was performed to compare the outcomes between patients with and without early tracheostomy.Results: Among 919 eligible patients, 654 patients (71%) underwent tracheostomy, with 136 patients (15%) receiving early tracheostomy. Overall, the median time from initiation of MV to tracheostomy was 12 days (interquartile range 8-15 days). After stabilized inverse probability of treatment weighting, early tracheostomy was not associated with lower in-hospital mortality (risk difference 0.4%; 95% confidence interval − 5.6 to 6.7%) compared with patients without early tracheostomy. There were no significant differences in 28-day mortality (risk difference − 1.3%; 95% confidence interval − 3.5 to 0.9%) and incidence of nosocomial pneumonia (risk difference − 2.6%; 95% confidence

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“…[5][6][7] The initial symptoms of GBS include muscle weakness that starts from distal limbs which subsequently progresses to proximal limbs. [8] GBS may lead to respiratory failure requiring mechanical ventilation over 15% of cases. [9] In some cases, GBS can affect the heart rate and changes the blood pressure by disrupting the autonomic nervous system.…”

Section: Guillain-barré Syndrome: Symptoms and Causesmentioning

confidence: 99%

Influenza vaccination and Guillain–Barré syndrome: Reality or fear

Babazadeh

Afshar

Javanian

et al. 2019

Journal of Translational Internal Medicine

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Guillain–Barré syndrome (GBS) is an inflammatory disorder and an acute immune-mediated demyelinating neuropathy that causes reduced signal transmissions, progressive muscle weakness, and paralysis. The etiology of the syndrome still remains controversial and uncertain. GBS can be initiated and triggered by respiratory tract infections such as influenza, and intestinal infections such as Campylobacter jejuni. In addition, there is considerable evidence suggesting links between influenza vaccination and GBS. As reported previously, the incidence of GBS in individuals receiving swine flu vaccine was about one to two cases per million. Despite the influenza vaccine efficacy, its association with an immune-mediated demyelinating process can be challenging as millions of people get vaccinated every year. In this review we will discuss the association between influenza infection and vaccination with GBS by focusing on the possible immunopathological mechanisms.

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Predictors of respiratory failure in patients with Guillain–Barré syndrome: a systematic review and meta‐analysis

Cited by 48 publications

References 37 publications

A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

Effect of Early Tracheostomy on Mortality of Mechanically Ventilated Patients with Guillain–Barré Syndrome: A Nationwide Observational Study

Influenza vaccination and Guillain–Barré syndrome: Reality or fear

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