A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

Ning, Pingping; Yang, Baiyuan; Yang, Xinglong; Zhao, Quanzhen; Huang, Hongyan; Shen, Qiuyan; Lü, Haitao; Tian, Sijia; Xu, Yanming

doi:10.1111/ane.13294

“…Predictors of the need for ventilatory support in GBS include cranial nerve involvement and a history of infection in the 8 days before the onset of symptoms. Paraclinical prognostic factors are reduced action potential amplitude in phrenic nerve stimulation and diaphragm examination, and high cerebrospinal fluid protein levels ( Ning et al, 2020 ; Wen et al, 2021 ). In addition, life-threatening complications due to dysautonomia are seen in more than one-third of the patients ( Chakraborty et al, 2020 ).…”

Section: Respiratory Dysfunction By Viral Infectionmentioning

confidence: 99%

Neurologic complications of coronavirus and other respiratory viral infections

Cavallieri

¹

,

Sellner

²

,

Zedde

³

et al. 2022

Handbook of Clinical Neurology

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“…However, the multivariate analysis showed that the only significant predictors were bulbar palsy (AOR 10.4) and weakness of hip flexors of MRC ≤ 3 (AOR 31.4). By comparison, bulbar weakness was a significant predictor of respiratory failure in several studies ( Malaga et al, 2021 ; Kanikannan et al, 2014 ; Toamad et al, 2015 ; Wu et al, 2015 ; Green, Baker & Subramaniam, 2018 ; Islam et al, 2019 ; Umer et al, 2019 ; Luo et al, 2020 ; Ning et al, 2020 ). Although the short time from symptom onset to admission (≤7 days) was a significant predictor in several studies ( Rantala et al, 1995 ; Toamad et al, 2015 ; Wu et al, 2015 ; Green, Baker & Subramaniam, 2018 ; Umer et al, 2019 ; Luo et al, 2020 ), it did not reach statistical significance in our univariate and multivariate analyses.…”

Section: Discussionmentioning

confidence: 92%

“…Respiratory failure is a common complication of GBS, caused by respiratory muscle weakness and impaired secretion clearance ( Green, Baker & Subramaniam, 2018 ). The prevalence of respiratory failure in GBS ranges from 13.0–50.9% ( Malaga et al, 2021 ; Shangab & Al Kaylani, 2021 ; Sharshar et al, 2003 ; Sudulagunta et al, 2015 ; Toamad et al, 2015 ; Umer et al, 2019 ; Ning et al, 2020 ). According to a recent meta-analysis, the clinical risk factors for respiratory failure in patients with GBS are a short time from symptom onset to hospital admission, bulbar or neck weakness, and severe muscle weakness on admission ( Green, Baker & Subramaniam, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical predictors and electrodiagnostic characteristics in patients with Guillain-Barré syndrome with respiratory failure: a retrospective, matched case-control study

Charoentanyarak

¹

,

Singjam

²

,

Saengsuwan

³

2022

PeerJ

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Background Respiratory failure is a common complication of Guillain-Barré syndrome (GBS). This study aimed to determine the clinical predictors and electrodiagnostic (EDx) characteristics in patients with Guillain-Barré syndrome (GBS) with respiratory failure. Methods The retrospective study included 29 confirmed GBS cases with respiratory failure and age- (±5 years) and sex-matched controls (1:1). The dependent t-test and McNemar–Bowker test were used to analyse the continuous and categorical data, respectively. In addition, a multiple logistic regression analysis was used to analyse the predictive factors for respiratory failure. Results Among both cases and controls, the majority were male (72.4%), and the average age was 50.9 years. The data showed that patients with respiratory failure had higher GBS disability scores, lower motor power (≤3) of the hip flexors and ankle dorsiflexors, and experienced facial and bulbar palsy. In the multivariate analysis, the significant predictive factors were bulbar palsy (AOR 10.4 [95% CI [2.6–41.4]) and motor power of hip flexors ≤ 3 (AOR 31.4 [95% CI [3.1–314.5]). Patients with respiratory failure had lower compound muscle action potential amplitude of the ulnar and tibial nerves. The median, ulnar, and tibial nerve conduction studies were more likely to reflect inexcitability. The GBS subtypes in GBS patients with and without respiratory failure were not significantly different. Conclusions Bulbar palsy and motor power of the hip flexors ≤ 3 were significant predictors for respiratory failure. The GBS subtypes in patients with and without respiratory failure were not significantly different.

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“…In addition to the 228 studies found from the initial database search, 20 further studies were identified through reference lists of relevant articles and Google Scholar and were added. After screening, 14 studies were included in the review [10][11][12][13][14][15][16][18][19][20][21][22][23]. Among them, ten studies had sufficient data to be included in the metaanalysis [10-16, 22, 24, 25].…”

Section: Resultsmentioning

confidence: 99%

Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

Sarejloo

¹

,

Khanzadeh

²

,

Hosseini

³

et al. 2022

Mediators of Inflammation

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In this study, we conducted a systematic review and meta-analysis regarding the role of the neutrophil to lymphocyte ratio (NLR) in Guillain Barré syndrome (GBS). The most recent update to the search was on July 18, 2022, through the databases of Web of Science, PubMed, Embase, and Scopus. The Newcastle-Ottawa scale was used for quality assessment of included studies. Finally, 14 studies were included in the review, and among them, ten studies were included in the meta-analysis. Our results showed that NLR levels were significantly increased in the patients with GBS compared with healthy controls ( SMD = 1.05 ; 95 % CI = 0.59 to 1.50, P < 0.001 ). After treatment, NLR levels were decreased to the extent that they became similar to healthy controls ( SMD = − 0.03 , 95 % CI = − 0.29 to 0.22, P = 0.204 ). Moreover, NLR was a stable predictor of outcome or response to treatment in such patients ( SMD = 1.01 , 95 % CI = 0.65 to 1.37, P < 0.001 ); the higher the NLR, the worse the outcome. In addition, patients who underwent mechanical ventilation had higher levels of NLR compared to those who did not ( SMD = 0.93 , 95 % CI = 0.05 to 1.82, P = 0.03 ). However, NLR levels were not different among distinct GBS subtypes, so it could not distinguish among them. In conclusion, our analysis indicates that the NLR levels are highly elevated in patients with GBS. Therefore, the NLR has the potential to be used as a biomarker to inform diagnosis, prognosis, or treatment responses in GBS, and future studies are warranted.

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A nomogram to predict mechanical ventilation in Guillain‐Barré syndrome patients

Cited by 16 publications

References 36 publications

Neurologic complications of coronavirus and other respiratory viral infections

Neurologic complications of coronavirus and other respiratory viral infections

Clinical predictors and electrodiagnostic characteristics in patients with Guillain-Barré syndrome with respiratory failure: a retrospective, matched case-control study

Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

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