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

OBJECTIVES: To analyze the clinical features associated with the need for mechanical ventilation (MV) in children with Guillain-Barré syndrome (GBS). DESIGN: Retrospective cohort study, 2010–2019. SETTING: PICU. PATIENTS: All children, 1 month to 12 years old, diagnosed with GBS in our single-center PICU. Intervention: Retrospective chart and data review. MEASUREMENTS AND MAIN RESULTS: Out of 189 children identified with a diagnosis of GBS, 130 were boys (69%). The median (interquartile range [IQR]) age was 6 years (3–9 yr). At admission, the Hughes disability score was 5 (4–5), and cranial nerve palsies were present in 81 children (42%). Autonomic instability subsequently occurred in a total of 97 children (51%). In the 159 children with nerve conduction studies, the axonal variant of GBS (102/159; 64%) predominated, followed by the demyelinating variant (38/189; 24%). All children received IV immunoglobulins as first-line therapy at the time of admission. The median (IQR) length of PICU stay was 12 days (3–30.5 d). Ninety-nine children (52%) underwent invasive MV, and median duration of MV was 25 days (19–37 d). At admission, upper limb power less than or equal to 3 (p = 0.037; odds ratio (OR), 3.5 [1.1–11.5]), lower limb power less than or equal to 2 (p = 0.008; OR, 3.5 [1.4–8.9]), and cranial nerve palsy (p = 0.001; OR, 3.2 [1.6–6.1]) were associated with subsequent need for MV. Prolonged (> 21 d) MV was associated w...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Neurocritical Care Source Type: research