Intravenous Immunoglobulin (IVIG) Versus Plasma Exchange (PE) for Ventilated Children With Guillain Barre Syndrome (GBS)

• PICU stay [ Time Frame: 28 days (average) ] [ Designated as safety issue: No ]
  How many days did the child spend on PICU
• Ability to walk [ Time Frame: 4 weeks from PICU discharge ] [ Designated as safety issue: No ]
  Ability of the child to walk unaided at 4 weeks from PICU admission

Comparing whether intravenous immune globulin or plasma exchange is superior in treating mechanically ventilated children with Guillain Barre syndrome.

Children with Guillain Barre syndrome (GBS) admitted to PICU at Mansoura University Children Hospital, Mansoura, Egypt with the need for mechanical ventilation were prospectively enrolled in the study.

Cases were diagnosed according to clinical criteria. The decisions to initiate, wean and terminate mechanical ventilation were made independently by the attending consultant in accordance with the unit guidelines.

Outcome variables measured were duration of mechanical ventilation, length of PICU stay and ability to walk unaided 4 weeks after PICU discharge.

• Drug: IVIG
  Intravenous Immune Globulin at a dose 0f 0.4 g/kg/day for 5 consecutive days
  Other Name: Sandglobin
• Procedure: Plasma Exchange
  Five sessions of plasma exchange, single plasma volume each, for 5 consecutive days
  Other Name: Plasmapheresis

• Active Comparator: IVIG group
  20 children randomized to receive IVIG for 5 days at a dose of 0.4 g/kg/day
  Intervention: Drug: IVIG
• Active Comparator: Plasma Exchange
  21 children randomized to receive 5 sessions of 1 volume plasma exchange per day for 5 consecutive days
  Intervention: Procedure: Plasma Exchange

Inclusion Criteria:

• Age: children from 1 month - 18 years old
• Clinical diagnosis of Guillain Barre syndrome
• Requirement of mechanical ventilation

Exclusion Criteria:

• Need for mechanical ventilation beyond 14 days from disease onset
• Child receiving IVIG or PE prior to enrollment