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Respiratory Muscle Assessment in Acute Guillain–Barré Syndrome

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Abstract

Purpose

Guillain–Barré Syndrome (GBS) is a life-threatening disease due to respiratory muscle involvement. This study aimed at objectively assessing the course of respiratory muscle function in GBS subjects within the first week of admission to an intensive care unit.

Methods

Medical Research Council Sum Score (MRC-SS), vigorimetry, spirometry, and respiratory muscle function tests (inspiratory/expiratory muscle strength: PImax/PEmax, sniff nasal pressure: SnPna) were assessed twice daily. GBS Disability Score (GBS-DS) was assessed once daily. On days one (d1) and seven (d7), blood gases and twitch mouth pressure during magnetic phrenic nerve stimulation (Pmo,tw) were additionally evaluated.

Results

Nine subjects were included. MRC-SS, vigorimetry, PImax, and SnPna increased between d1 and d7. GBS-DS, spirometry and Pmo,tw remained unaltered. Only SnPna correlated closely with the MRC-SS on both d1 (r = 0.77, p = 0.02) and d7 (r = 0.74, p = 0.02).

Conclusion

SnPna was the only parameter that correlated with MRC-SS, while the current gold standard of spirometry measurement did not.

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Abbreviations

ANOVA:

One-way analysis of variance

CMAP:

Compound muscle action potential

GBS:

Guillain–Barré Syndrome

GBS-DS:

Erasmus GBS Disability Score

MRC-SS:

MRC Sum Score

P0.1 :

Respiratory drive

PEmax :

Global maximal expiratory muscle strength

PImax :

Global maximal inspiratory muscle strength

Pmo,tw:

Twitch mouth pressure

SD:

Standard deviation

SnPna:

Sniff nasal pressure

VC:

Vital capacity

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Acknowledgments

All participants are acknowledged for their time and effort.

Funding

This work was supported by a research grant from the German Research Foundation DFG (Deutsche Forschungsgemeinschaft), Bonn, Germany [KA 2992/2-1].

Author information

Authors and Affiliations

  1. Clinic for Pneumology, Department of Internal Medicine, University Hospital Freiburg, Freiburg, Germany

    S. Walterspacher, A. Kirchberger, D. J. Walker, A. Schwörer, W. Windisch & H. J. Kabitz

  2. Department of Neurology, University Hospital Freiburg, Freiburg, Germany

    J. Lambeck, W. D. Niesen & F. Hamzei

  3. Department of Pneumology, Kliniken der Stadt Köln gGmbH Cologne, University of Witten/Herdecke, Witten, Germany

    S. Walterspacher, D. J. Walker & W. Windisch

  4. Section of Neurological Rehabilitation, Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany

    F. Hamzei

  5. Department of Pneumology, Cardiology, Intensive Care Medicine, Academic Teaching Hospital University Freiburg, Klinikum Konstanz, Luisenstrasse 7, 78464, Constance, Germany

    S. Walterspacher, D. J. Walker & H. J. Kabitz

Authors
  1. S. Walterspacher
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  2. A. Kirchberger
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  3. J. Lambeck
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  4. D. J. Walker
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  6. W. D. Niesen
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  7. W. Windisch
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  9. H. J. Kabitz
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Correspondence to S. Walterspacher.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in this study.

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Walterspacher, S., Kirchberger, A., Lambeck, J. et al. Respiratory Muscle Assessment in Acute Guillain–Barré Syndrome. Lung 194, 821–828 (2016). https://doi.org/10.1007/s00408-016-9929-5

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  • DOI: https://doi.org/10.1007/s00408-016-9929-5

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