CLINICAL OUTCOME OF GUILLAIN BARRE SYNDROME IN THE INTENSIVE CARE UNIT OF A PEDIATRIC TERTIARY CARE HOSPITAL

Authors

  • W AMIN Pediatrician, Sindh Government Children Hospital Karachi, Pakistan
  • S ARSHAD Pediatrician, Rural Health Centre district Kemari Karachi, Pakistan
  • S IQBAL Pediatrician, The National Institute of Child Health Karachi (NICH) Karachi, Pakistan
  • A AHMED Assistant Professor National Institute of Child Health Karachi, Pakistan
  • MSBF AWAN BHU Sulmiya, District Jhelum Valley, Azad Jammu and Kashmir /Department of Accident and Emergency, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.570

Keywords:

Guillain-Barre Syndrome, Clinical Outcome, Intensive Care Unit

Abstract

Since poliomyelitis was eradicated, Guillain-Barre syndrome has been the leading cause of acute flaccid paralysis globally. Critical care and mechanical breathing may be necessary in extreme circumstances. Among paediatric patients hospitalized in the intensive care unit of a Karachi tertiary hospital, we aimed to quantify the incidence of Guillain-Barré Syndrome clinical outcomes. Cardiology Intensive Care Unit (NICH) in Karachi, Pakistan. January 9, 2020, to July 10, 2020—six months. Children admitted to the intensive care unit at NICH with GBS, as defined operationally, ranging in age from six months to twelve years, were included in the study. They stimulated the posterior tibial nerve (PTN) and common peroneal nerve (CPN), allowing for studying motor nerve conduction and using the median and ulnar nerves to measure compound muscle action potentials' onset delay, amplitude and conduction velocity (CMAPs). Research on the conduction of sensory nerves was carried out to quantify SNAPs in the sural, median, and ulnar regions. All patients were given intravenous immunoglobulin for five days at a 400 mg/kg/day dosage, as per the protocol. Clinical outcomes were evaluated using the HFG scale at discharge and four weeks. The average patient age was 5.81 ± 3.26 years out of 30. Thirteen men (43.3%) and seventeen females (56.7%) were present. Fifteen patients (53.3%) had a history of upper respiratory illness, while seven (23.3%) had a history of gastrointestinal infection. A mean HFG score of 3.03 ±1.90 was recorded. Outcomes were good for 21 patients (56.7%) and deficient for 9 (43.3%). A tertiary care hospital in Karachi reported that 56.7% of children admitted with Guillain-Barre Syndrome had good clinical results in the intensive care unit.

Downloads

Download data is not yet available.

References

Bazaraa, H. M., Rady, H. I., Mohamed, S. A., Rabie, W. A., & ElAnwar, N. H. (2019). Initial Response and Outcome of Critically Ill Children With Guillain Barre'Syndrome. Frontiers in Pediatrics, 7, 378.

Chalela, J. A. (2001). Pearls and pitfalls in the intensive care management of Guillain-Barré syndrome. Paper presented at the Seminars in neurology.

Chand, P., Jan, F., Kaleem, S., Yousafzai, M. T., & Ibrahim, S. (2017). Description of Guillain-Barre syndrome on the basis of clinical features using Hughes scoring system among children in Karachi, Pakistan. Asia Pacific Journal of Clinical Trials: Nervous System Diseases, 2(2), 45.

Cheng, Q., Jiang, G. X., Press, R., Andersson, M., Ekstedt, B., Vrethem, M., . . . Fredrikson, S. (2000). Clinical epidemiology of Guillain–Barré syndrome in adults in Sweden 1996–97: a prospective study. European Journal of Neurology, 7(6), 685-692.

Diener, H.-C., Haupt, W. F., Kloss, T. M., & Rosenow, F. (2001). A preliminary, randomized, multicenter study comparing intravenous immunoglobulin, plasma exchange, and immune adsorption in Guillain-Barré syndrome. European neurology, 46(2), 107.

El-Bayoumi, M. A., El-Refaey, A. M., Abdelkader, A. M., El-Assmy, M. M., Alwakeel, A. A., & El-Tahan, H. M. (2011). Comparison of intravenous immunoglobulin and plasma exchange in treatment of mechanically ventilated children with Guillain Barré syndrome: a randomized study. Critical Care, 15, 1-6.

Ghazavi, A., Abbasi, E., & Mohammadi, S. (2020). Evaluation of demographic, clinical and paraclinical features of children with Guillain-Barré syndrome. Journal of Preventive Epidemiology, 5(2), e23-e23.

Halawa, E. F., Ahmed, D., & Nada, M. A. (2011). Guillain-Barré syndrome as a prominent cause of childhood acute flaccid paralysis in post polio eradication era in Egypt. European journal of paediatric neurology, 15(3), 241-246.

Kumar, M., Aroor, S., Mundkur, S., & Kumar, S. (2015). Guillain-barré syndrome: a clinical study of twenty children. Journal of clinical and diagnostic research: JCDR, 9(1), SC09.

McGrogan, A., Madle, G. C., Seaman, H. E., & De Vries, C. S. (2009). The epidemiology of Guillain-Barré syndrome worldwide: a systematic literature review. Neuroepidemiology, 32(2), 150-163.

McKhann, G., Griffin, J., Cornblath, D., Mellits, E., Fisher, R., Quaskey, S., & Group, G. B. S. S. (1988). Plasmapheresis and Guillain‐Barré syndrome: analysis of prognostic factors and the effect of plasmapheresis. Annals of neurology, 23(4), 347-353.

Mitsui, Y., Kusunoki, S., Arimura, K., Kaji, R., Kanda, T., Kuwabara, S., . . . Takada, K. (2015). A multicentre prospective study of Guillain-Barré syndrome in Japan: a focus on the incidence of subtypes. Journal of Neurology, Neurosurgery & Psychiatry, 86(1), 110-114.

Momen, A. A., & Shakurnia, A. (2016). An epidemiological analysis of acute flaccid paralysis in Khuzestan Province, southwest Iran, from 2006 to 2010. Epidemiology and Health, 38.

Omejec, G., & Podnar, S. (2012). Retrospective analysis of Slovenian patients with Guillain‐Barré syndrome. Journal of the peripheral nervous system, 17(2), 217-219.

Ra, H., Mb, S., Rc, I., Ad, R., NBe, B., & MAf, H. (2017). Clinical profile of Guillain Barre'syndrome-observations from a tertiary care hospital of Bangladesh.

Rees, J., Thompson, R., Smeeton, N., & Hughes, R. (1998). Epidemiological study of Guillain-Barré syndrome in south east England. Journal of Neurology, Neurosurgery & Psychiatry, 64(1), 74-77.

Saad, K., Mohamad, I. L., Abd El-Hamed, M. A., Tawfeek, M. S., Ahmed, A. E., Abdel Baseer, K. A., . . . Tamer, D. M. (2016). A comparison between plasmapheresis and intravenous immunoglobulin in children with Guillain–Barré syndrome in Upper Egypt. Therapeutic Advances in Neurological Disorders, 9(1), 3-8.

Sadek, A. A., Abou-Taleb, A., & Ali, W. A. (2016). Outcome of Guillain-Barré Syndrome in Children: A prospective cohort study in a tertiary hospital in Upper Egypt. Electronic physician, 8(12), 3318.

Sundar, U., Abraham, E., Gharat, A., Yeolekar, M., Trivedi, T., & Dwivedi, N. (2005). Neuromuscular respiratory failure in Guillain-Barre Syndrome: evaluation of clinical and electrodiagnostic predictors. The Journal of the Association of Physicians of India, 53, 764-768.

Tang, J., Dai, Y., Li, M., Cheng, M., Hong, S., Jiang, L., . . . Zhong, M. (2011). Guillain-Barré syndrome in Chinese children: a retrospective analysis. Pediatric neurology, 45(4), 233-237.

van Koningsveld, R., Schmitz, P., Van der Meche, F., Visser, L., Meulstee, J., & Van Doorn, P. (2004). Effect of methylprednisolone when added to standard treatment with intravenous immunoglobulin for Guillain-Barré syndrome: randomised trial. The Lancet, 363(9404), 192-196.

Verboon, C., Van Doorn, P. A., & Jacobs, B. C. (2017). Treatment dilemmas in Guillain-Barré syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 88(4), 346-352.

Willison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016). Guillain-barre syndrome. The Lancet, 388(10045), 717-727.

Yakoob, M. Y., Rahman, A., Jamil, B., & Syed, N. A. (2005). Characteristics of patients with Guillain Barre Syndrome at a tertiary care centre in Pakistan, 1995-2003. Journal of Pakistan Medical Association, 55(11), 493.

Yuki, N., & Hartung, H.-P. (2012). Guillain–barré syndrome. New England Journal of Medicine, 366(24), 2294-2304.

Downloads

Published

2023-12-08

How to Cite

AMIN , W., ARSHAD , S., IQBAL , S., AHMED , A., & AWAN, M. (2023). CLINICAL OUTCOME OF GUILLAIN BARRE SYNDROME IN THE INTENSIVE CARE UNIT OF A PEDIATRIC TERTIARY CARE HOSPITAL. Biological and Clinical Sciences Research Journal, 2023(1), 570. https://doi.org/10.54112/bcsrj.v2023i1.570