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Guillain-Barré syndrome. Specific features of intensive care, potential for therapeutic use of plasmapheresis, and our experience


Authors: R. Zazula;  T. Řezáč;  J. Cihlář
Authors‘ workplace: Přednosta: MUDr. Roman Zazula Ph. D. ;  Anesteziologicko-resuscitační klinika 1. LF UK a FTNsP, Praha
Published in: Prakt. Lék. 2008; 88(10): 582-588
Category: Of different specialties

Overview

Guillain-Barré syndrome (GBS) is a group of autoimmune diseases consisting of demyelinization forms and axonal degenerative forms. The individual subtypes can be distinguished using electrophysiological investigation, particularly by conduction studies. The disease is usually preceded by infection by some known pathogen triggering an autoimmune-based cross-reaction affecting peripheral nerve tissue. The patient develops symmetrical muscular weakness persisting for some time, with subsequent progressive improvement of the condition, usually with complete recovery without any sequels. The risk of death with the severe forms is associated primarily with dysautonomy and respiratory failure requiring mechanical lung ventilation. It is particularly these most severe cases which require comprehensive intensive care. Management involves specific immunomodulatory therapy with therapeutic plasmapheresis or intravenous immunoglobulin administration, combined with supportive therapy including mechanical lung ventilation, required by about one in ten patients. The review includes our own experience with the management of severe GBS in the authors’ department.

Key words:
Guillain-Barré syndrome, mechanical lung ventilation, plasmapheresis, intravenous immunoglobulin.


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