[Treatment of Guillain-Barré syndrome by plasma exchange: proposal of a therapeutic strategy].
Although the favorable effect of plasma exchange (PE) has been demonstrated in Guillain-Barré syndrome, the optimal number of PE and management at different degrees of gravity remain to be ascertained. A new controlled multicentric trial is therefore being conducted since 1986. Mid-term results show that 2 PE give better results than 0 in patients who are still able to walk. Inversely, 6 PE do not give better results when ventilatory assistance was initially required. It is therefore logical to propose 2PE as early as possible. Two supplementary PE can be used in case of disease progression. Use of high dose immunoglobulins is not justified except when PE is contraindicated.
Raphael
J C
JC
Service de Réanimation Médicale, Hôpital Raymond Poincaré, Garche
Chevret
S
S
Jars-Guincestre
M C
MC
Chastang
C
C
Gajdos
P
P
D006801:Humans; D010951:Plasma Exchange; D011129:Polyradiculoneuropathy / Q000628:therapy*; D016896:Treatment Outcome