Small volume plasma exchange in Guillain-Barre syndrome: experience in 25 patients.
The impact of small volume plasma exchange (PE) on the treatment of Guillain-Barre syndrome (GBS) was studied by comparing 25 patients treated with PE since 1982 with 25 historic controls treated without PE prior to 1982. Small volume PE was done by removing 10-15 ml plasma/kg body weight daily till the progression of the disease was arrested or recovery started. The PE group started recovering earlier (median 3 days, compared to 17.5 days in controls, 2P = 0.01), attained better clinical grades at the end of the 1st and 3rd months (2P = 0.001), and took much shorter time to recover by one clinical grade (median 15 days, compared to 53 days in controls, 2P = 0.01). The median duration of ventilation among the surviving patients was shorter in the PE group (8 days compared to 24.5 days, 2P = 0.10) and total number of complications was less in the PE group (15 events compared to 22 in the controls, 2P = 0.05). Three months after the onset of neuropathy, 13/25 controls were still bed bound, whereas only 4/25 in the PE group remained in that grade (2P = 0.02). There was no significant difference in the mortality rate in two groups (2P = 0.09), but the difference was significant in the subgroup of patients who were ventilated (2P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Tharakan
J
J
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum.
Jayaprakash
P A
PA
Iyer
V P
VP
D000293:Adolescent; D000328:Adult; D006801:Humans; D010951:Plasma Exchange; D011129:Polyradiculoneuropathy / Q000150:complications / Q000628:therapy*