• Critical care medicine · Mar 2019

    Dysglycemia and Neurologic Outcome in Mechanically Ventilated Patients With Guillain-Barré Syndrome.

    • Andrea Polito, Angelo Polito, Eléonore Bouchereau, Guy Moneger, Thomas Ritzenthaler, Djillali Annane, Nicholas Heming, and Tarek Sharshar.
    • Adult Intensive Care Unit, University Hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
    • Crit. Care Med. 2019 Mar 1; 47 (3): e227-e233.

    ObjectivesAcute respiratory failure is a frequent complication of Guillain-Barré syndrome, associated with high morbidity and mortality. Adjuvant treatments are needed to improve the outcome of Guillain-Barré syndrome. Since dysglycemia is a risk factor for development of axonal polyneuropathy in critically ill patients and since insulin therapy may be neuroprotective, we sought to explore the association between dysglycemia and neurologic status in Guillain-Barré syndrome patients.DesignRetrospective study.SettingSingle-center study.InterventionsAll plasma levels of glycemia measured by enzymatic technique as well as capillary glycemia were collected in a cohort of mechanically ventilated Guillain-Barré syndrome patients. Insulin administration and dysglycemia were correlated to neurologic status at discharge defined by disability grade and arm grade.Measurements And Main ResultsIn a multivariate analysis, disability grade and arm grade at ICU discharge were independently and inversely correlated with mean blood glucose. Disability grade and arm grade did not correlate with any other dysglycemic variables or with insulin administration or length of stay.ConclusionsIn the present study, we found that neurologic disability at ICU discharge correlated with dysglycemia in mechanically ventilated Guillain-Barré syndrome patients. These finding indicates that dysglycemia may delay motor recovery and impact the functional outcome of Guillain-Barré syndrome. Blood glucose control might be an adjuvant therapy for improving Guillain-Barré syndrome recovery.

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