{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:52:49Z","timestamp":1790887969971,"version":"4.1.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2011,7,11]],"date-time":"2011-07-11T00:00:00Z","timestamp":1310342400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,7,11]],"date-time":"2011-07-11T00:00:00Z","timestamp":1310342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Respiratory failure is a life threatening complication of Guillain Barr\u00e9 syndrome (GBS). There is no consensus on the specific treatment for this subset of children with GBS.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>This was a prospective randomized study to compare the outcome of intravenous immunoglobulin (IVIG) and plasma exchange (PE) treatment in children with GBS requiring mechanical ventilation. Forty-one children with GBS requiring endotracheal mechanical ventilation (MV) within 14 days from disease onset were included. The ages of the children ranged from 49 to 143 months.<\/jats:p>\n                        <jats:p>Randomly, 20 children received a five-day course of IVIG (0.4 g\/kg\/day) and 21 children received a five-day course of one volume PE daily. Lumbar puncture (LP) was performed in 36 patients (18 in each group).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Both groups had comparable age (<jats:italic>p<\/jats:italic> = 0.764), weight (<jats:italic>p<\/jats:italic> = 0.764), duration of illness prior to MV (<jats:italic>p<\/jats:italic> = 0.854), preceding diarrhea (<jats:italic>p<\/jats:italic> = 0.751), cranial nerve involvement (<jats:italic>p<\/jats:italic> = 0.756), muscle power using Medical Research Council (MRC) sum score (<jats:italic>p<\/jats:italic> = 0.266) and cerebrospinal fluid (CSF) protein (<jats:italic>p<\/jats:italic> = 0.606).<\/jats:p>\n                        <jats:p>Children in the PE group had a shorter period of MV (median 11 days, IQR 11.0 to 13.0) compared to IVIG group (median 13 days, IQR 11.3 to 14.5) with <jats:italic>p<\/jats:italic> = 0.037.<\/jats:p>\n                        <jats:p>Those in the PE group had a tendency for a shorter Pediatric Intensive Care Unit (PICU) stay (<jats:italic>p<\/jats:italic> = 0.094).<\/jats:p>\n                        <jats:p>A total of 20\/21 (95.2%) and 18\/20 (90%) children in the PE and IVIG groups respectively could walk unaided within four weeks after PICU discharge (<jats:italic>p<\/jats:italic> = 0.606).<\/jats:p>\n                        <jats:p>There was a negative correlation between CSF protein and duration of mechanical ventilation in the PE group (<jats:italic>p<\/jats:italic> = 0.037), but not in the IVIG group (<jats:italic>p<\/jats:italic> = 0.132).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>In children with GBS requiring MV, PE is superior to IVIG regarding the duration of MV but not PICU stay or the short term neurological outcome.<\/jats:p>\n                        <jats:p>The negative correlation between CSF protein values and duration of MV in PE group requires further evaluation of its clinical usefulness.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Trial Registration<\/jats:title>\n                        <jats:p>Clinicaltrials.gov Identifier <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT01306578\">NCT01306578<\/jats:ext-link><\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc10305","type":"journal-article","created":{"date-parts":[[2011,7,12]],"date-time":"2011-07-12T06:20:57Z","timestamp":1310451657000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["Comparison of intravenous immunoglobulin and plasma exchange in treatment of mechanically ventilated children with Guillain Barr\u00e9 syndrome: a randomized study"],"prefix":"10.1186","volume":"15","author":[{"given":"Mohammed A","family":"El-Bayoumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M","family":"El-Refaey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa M","family":"Abdelkader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed MA","family":"El-Assmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angi A","family":"Alwakeel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanem M","family":"El-Tahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,7,11]]},"reference":[{"key":"9574_CR1","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1212\/01.wnl.0000310983.38724.d4","volume":"70","author":"A Alshekhlee","year":"2008","unstructured":"Alshekhlee A, Hussain Z, Sultan B, Katirji B: Guillain-Barr\u00e9 syndrome: incidence and mortality rates in US hospitals. 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