Hostname: page-component-7479d7b7d-k7p5g Total loading time: 0 Render date: 2024-07-11T13:39:43.587Z Has data issue: false hasContentIssue false
  • English
  • Français

Intensive Care of Acute Guillain-Barre Syndrome

Published online by Cambridge University Press:  12 November 2018

Allan H. Ropper
Allan H. Ropper*
Affiliation:
Neurology Service, St. Elizabeth's Hospital, Boston and Tufts University School of Medicine
*
Reprint requests to: Allan H. Ropper, M.D. Neurology Service, St. Elizabeth's Hospital, Boston, Massachusetts, U.S.A. 02135
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Guillain-Barré syndrome causes, in addition to paralysis and respiratory failure, many general medical problems that have great bearing on outcome. The main features of daily care that require attention are: respiratory and urinary tract infections, gastrointestinal dysfunction, hyponatremia, pain control, and the potential for pulmonary embolism. Dysautonomic problems that arise specifically in the intensive care unit include: hyper- and hypotension, cardiac arrhythmias, and ileus. Throughout the illness, certain psychological aberrations and communication problems must be addressed. The experience reviewed herein provides a practical approach to these problems.

Résumé

Résumé

Le syndrome de Guillain-Barré cause plusieurs problèmes médicaux généraux, en plus de la paralysie et de l'insuffisance respiratoire, qui ont une influence importante sur Tissue de la maladie. Les principaux aspects des soins quotidiens qui demandent une attention particulière sont: les infections des voies respiratoires et urinaires, la dysfonction gastrointestinale, l'hyponatrémie, le contrôle de la douleur et le risque d'embolie pulmonaire. Les problèmes dus à la dysautonomie, qui se présentent spécifiquement à l'unité de soins intensifs, incluent: l'hypertension et l'hypotension, les arythmies cardiaques et l'occlusion intestinale. Pendant toute la maladie, on doit tenir compte de certaines aberrations psychologiques et de problèmes de communication. L'expérience présentée propose une approche pratique de ces problèmes.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue S1: Neurocritical Care Symposium , February 1994 , pp. S23 - S27
Copyright
Copyright © The Canadian Journal of Neurological 1994

References

1. Ropper, AH, Wijdicks, EFM, Truax, BT. Guillain-Barre syndrome. FA Davis, Philadelphia, 1991.Google Scholar
2. Ropper, AH. Critical care of Guillain-Barre syndrome. In: Neurological and Neurosurgical Intensive Care. AH Ropper, ed. New York: Raven Press, 1994.Google Scholar
3. Hund, EF, Borel, CO, Cornblath, DR, et al. Intensive management of severe Guillain-Barre syndrome. Crit Care Med 1994; 21: 433–446.Google Scholar
4. Raman, TK, Blake, JA, Harris, TM. Pulmonary embolism in Landry-Guillain-Barre-Strohl syndrome. Chest 1971; 60: 555–556.Google Scholar
5. Gracey, DR, McMichan, JC, Divertie, MB, Howard, FM. Respiratory failure in Guillain-Barre syndrome. A 6-year experience. Mayo Clin Proc 1982;57:742–746.Google Scholar
6. Feldman, JM. Cardiac arrest after succinylcholine administration in a pregnant patient recovered from Guillain-Barre syndrome. Anesthesiology 1990; 72: 942–944.CrossRefGoogle Scholar
7. Meythaler, JM, Korkor, AB, Nanda, T, Kumar, NA, Fallon, M. Immobilization hypercalcemia associated with Landry-Guillain-Barre syndrome. Successful therapy with combined calcitonin and etidronate. Arch Intern Med 1986; 146: 1567–1571.Google Scholar
8. Ropper, AH, Shahani, BT. Pain in Guillain-Barre syndrome. Arch Neurol 1984;41:511–514.CrossRefGoogle Scholar
9. Rosenfeld, B, Borel, C, Hanley, D. Epidural morphine treatment of pain in Guillain-Barre syndrome. Arch Neurol 1986; 43: 1194–1196.Google Scholar
10. McCarthy, JA, Zigenfus, RW. Transcutaneous electrical nerve stimulation: an adjunct in the pain management of Guillain-Barre syndrome. Phys Ther 1978; 58: 23–24.Google Scholar
11. Bowes, D. The doctor as patient: an encounter with Guillain-Barre syndrome. Can Med Assoc J 1984; 131: 1343–1348.Google Scholar
12. Rice, D. Landry Guillain-Barre syndrome: personal experience of acute ascending paralysis. Br Med J 1977; 1: 1330–1332.Google Scholar
13. Baier, S, Zimmeth-Schomaker. Woman in Bed Number 10. CRC Press, Inc., Bacoa Raton, 1985.Google Scholar
14. Durocher, A, Servais, B, Caridroix, M, Chopin, C, Wattel, F. Autonomic dysfunction in the Guillain-Barre syndrome. Hemodynamic and neurochemical studies. Intensive Care Med 1980; 6: 3–6.Google Scholar
15. Ropper, AH, Wijdicks EFM. Blood pressure fluctuations in the dysautonomia of Guillian-Barre syndrome. Arch Neurol 1990; 47: 706–708.Google Scholar
16. Dalos, NP, Borel, C, Hanley, DF. Cardiovascular autonomic dysfunction in Guillain-Barre syndrome. Therapeutic implications of Swan-Ganz monitoring. Arch Neurol 1988; 45: 115–117.CrossRefGoogle Scholar
17. Goulon, M, Raphael, J-C, Gajdos, PH, Patte, D. Bradycardie et reflexe oculo-cardiaque au cours du syndrome de Landry-Guillain-Barre. Presse Med 1978; 7: 1866.Google Scholar
18. Winer, JB, Hughes RAC. Identification of patients at risk of arrhythmia in Guillain-Barre syndrome. Q J Med 1988; 68: 735–739.Google Scholar