Intravenous immunoglobulin vs plasma exchange in treatment of mechanically ventilated adults with Guillain-Barré syndrome

INTRODUCTION The aim of the study is to compare efficacy of IvIg versus PE in treatment of mechanically ventilation adults with GBS in intensive care unit. METHODS It is a prospective, non randomized study, realized in a medical ICU from 2006 to 2010. We included all patients with GBS who required mechanical ventilation (MV). We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 4 PE during 10-14 days). We collected demographic characteristics, clinical and therapeutic aspects and outcome. STATISTICAL ANALYSIS USED The quantitative variables are expressed on mean ± standard derivation and compared by Student test. The statistic analysis has been based on SPSS for windows. P<0.05 is considered as significant. RESULTS Forty-one patients (21 in group 1 and 20 in group 2) were enrolled. The mean age was 37.4±9.2 years, with a masculine predominance (75.4%). Electromyogram in all patients found acute inflammatory demyelinating polyradiculoneuropathy in 80.5% of patients. The mean length of hospitalization was 45.3±9.2 days. The length of hospitalization of the IvIg group is less long than PE group (p=0.03). The weaning of the MV was more precocious in IvIg group than PE group (p=0.01). Also, the beginning of motility recuperation was precocious at IvIg group than PE group (p=0.04). CONCLUSION Our work reveals a meaningful difference for the MV weaning and precocious recovery in IvIg group compared to PE group.