Alqahtani Samah, Al-Dorzi Hasan M, Arishi Hatim, Peeran Ahmad, Bin Humaid Felwa, Alenezi Farhan Zayed, Jose Jesna, Sadat Musharaf, Alotaibi Naser, Arabi Yaseen M
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Intensive Care Department, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Neurology Department, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
J Int Med Res. 2024 Dec;52(12):3000605241306655. doi: 10.1177/03000605241306655.
To evaluate characteristics and outcomes in critically ill patients with Guillain-Barré syndrome (GBS).
Consecutive adults with GBS who required intensive care unit (ICU) admission at a tertiary-care hospital between 1999 and 2020 were enrolled into this retrospective cohort study. Demographics, clinical data and patient outcomes were compared between patients who did or did not receive mechanical ventilation (MV).
During the study period, the number of ICU admissions gradually rose from approximately 900 to 3000 annually. Forty-three patients had GBS and were included, of whom, 27 (62.8%) received MV for a median of 13 days. The MV group stayed longer in the ICU (median, 26 versus 6 days) and in the hospital (median, 120 versus 39 days) than the non-MV group. Most patients in the MV group (22 [81.5%]) required tracheostomy. At maximum follow-up, Hughes Functional Grading scores were 0 (full recovery) in 11 patients (25.5%), 1-3 in 18 (41.8%), 4-5 in 12 (27.9%), and 6 (death) in two (4.6%, both in the MV group), with higher median Hughes score in the MV group (3 versus 0.5). Complications during ICU and hospital stay included: veinous thromboembolism in five (11.6%), gastrointestinal bleeding in three (7.0%), bacteremia in five (11.6%), bedsore in one (2.3%), and GBS-treatment side effects in four (9.4%) patients; all of these complications occurred within the MV group.
GBS was an uncommon reason for ICU admission. The findings highlight significant morbidity with GBS, particularly among patients who need MV.
评估吉兰-巴雷综合征（GBS）危重症患者的特征及预后。
本回顾性队列研究纳入了1999年至2020年间在一家三级医院因GBS需入住重症监护病房（ICU）的连续成年患者。比较接受或未接受机械通气（MV）患者的人口统计学、临床数据及患者预后。
研究期间，每年入住ICU的人数从约900人逐渐增至3000人。纳入43例GBS患者，其中27例（62.8%）接受了MV，中位时间为13天。MV组在ICU的停留时间（中位数，26天对6天）和住院时间（中位数，120天对39天）均长于非MV组。MV组的大多数患者（22例[81.5%]）需要气管切开术。在最长随访时，11例患者（25.5%）的休斯功能分级评分为0（完全恢复），18例（41.8%）为1 - 3分，12例（27.9%）为4 - 5分，2例（4.6%，均在MV组）为6分（死亡），MV组的休斯评分中位数更高（3分对0.5分）。ICU和住院期间的并发症包括：5例（11.6%）发生静脉血栓栓塞，3例（7.0%）发生胃肠道出血，5例（11.6%）发生菌血症，1例（2.3%）发生压疮，4例（9.4%）发生GBS治疗副作用；所有这些并发症均发生在MV组。
GBS是入住ICU的罕见原因。研究结果凸显了GBS的高发病率，尤其是在需要MV的患者中。
