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Home arrow Environment arrow Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management
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Treatment of GBS

Treatment of GBS consists of supportive treatment as well as immunotherapy in more severe cases. Supportive care is better provided in an intensive care unit in the progressive phase of the disease.

Supportive Treatment

Respiratory care

Respiratory failure is one of the most serious short-term complications of GBS. About 25% of patients with GBS who are unable to walk and 30-50% of patients who are admitted to ICU undergo intubation and mechanical ventilation [43]. The need for mechanical ventilation should be anticipated in GBS when there is rapidly progressive course as manifested by time to peak disability less than 7 days, time from the onset of symptoms to hospitalization less than 7 days, and presence of more than 30% reduction of vital capacity, NIF, and PEF during the course of hospitalization [44, 45]. It is essential to anticipate the need for mechanical ventilation (MV) and proceed with elective intubation in selected patients. It is therefore recommended to assess FVC every 2-4 h during the day and every 4-6 h at night in a patient with declining respiratory function. A vital capacity of less than 20 mL/kg, maximal inspiratory pressure less than 30 cm H2O, maximal expiratory pressure less than 40 cm H2O, and a reduction of more than 30% in vital capacity, maximal inspiratory pressure, or maximal expiratory pressure anticipate need for oncoming respiratory failure [44]. Elective intubation and MV are recommended in patients with significant respiratory distress, fatigue, sweating, tachycardia, active aspiration, FVC < 15 mL/kg, hypercarbia (PaCO2 48 mm Hg), and hypoxemia (PaO2 on room air <56 mm Hg) [1, 46].

 
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