Neurocritical Care

, Volume 15, Issue 1, pp 128–133

Selective Digestive Tract Decontamination Decreases Time on Ventilator in Guillain–Barré Syndrome

  • Martine E. Bos Eyssen
  • Pieter A. van Doorn
  • Bart C. Jacobs
  • Ewout W. Steyerberg
  • Peter H. J. van der Voort
  • Durk F. Zandstra
  • Janneke Horn
  • Peter E. Spronk
  • Cornelia W. Hoedemaekers
  • Jan Bakker
  • Mathieu van der Jagt
Original Article

DOI: 10.1007/s12028-011-9536-5

Cite this article as:
Bos Eyssen, M.E., van Doorn, P.A., Jacobs, B.C. et al. Neurocrit Care (2011) 15: 128. doi:10.1007/s12028-011-9536-5

Abstract

Background

Ventilator-associated pneumonia (VAP) occurs in more than half of mechanically ventilated patients with Guillain–Barré syndrome (GBS) and is associated with prolonged mechanical ventilation (MV). We investigated the impact of selective decontamination of the digestive tract (SDD), an intervention that reduces hospital acquired infections in ICU patients, on duration of MV in GBS and neurological outcome at 6 months.

Methods

We performed a retrospective study in mechanically ventilated GBS patients in the Netherlands. We compared patients treated with and without SDD. Main outcomes were duration of MV and the ability to walk independently at 6 months. Statistical comparison was done with logistic and ordinal regression analyses.

Results

We included 124 GBS patients on MV at 2 weeks after first symptoms (SDD, n = 54 and non-SDD, n = 70). The median duration of MV without SDD was 42 days (interquartile range, IQR 25–77 days) versus 29 days with SDD (IQR 17–45 days). Median duration of MV for all included patients was 35 days. The adjusted odds ratio (OR) for duration of MV > 35 days in the SDD versus the non-SDD cohort was 0.37 (95% CI 0.17–0.77). SDD did not affect neurological recovery after 6 months from first symptoms. VAP occurred in 12% (95% CI 2–22%) in the SDD cohort and in 47% (95% CI 35–59%) in the non-SDD cohort.

Conclusions

SDD in mechanically ventilated GBS patients reduced the time on the ventilator, probably by preventing VAP, but did not affect neurological recovery after 6 months.

Keywords

Guillain–Barré syndrome SDD Mechanical ventilation Ventilator-associated pneumonia Prognosis 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Martine E. Bos Eyssen
    • 1
  • Pieter A. van Doorn
    • 1
  • Bart C. Jacobs
    • 1
    • 2
  • Ewout W. Steyerberg
    • 3
  • Peter H. J. van der Voort
    • 4
  • Durk F. Zandstra
    • 4
  • Janneke Horn
    • 5
  • Peter E. Spronk
    • 6
  • Cornelia W. Hoedemaekers
    • 7
  • Jan Bakker
    • 8
  • Mathieu van der Jagt
    • 8
  1. 1.Department of NeurologyErasmus MC-University Medical CenterRotterdamThe Netherlands
  2. 2.Department of ImmunologyErasmus MC-University Medical CenterRotterdamThe Netherlands
  3. 3.Department of Public HealthErasmus MC-University Medical CenterRotterdamThe Netherlands
  4. 4.Department of Intensive CareOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  5. 5.Department of Intensive CareAcademic Medical CenterAmsterdamThe Netherlands
  6. 6.Department of Intensive CareGelre HospitalApeldoornThe Netherlands
  7. 7.Department of Intensive CareRadboud University Nijmegen Medical CenterNijmegenThe Netherlands
  8. 8.Department of Intensive CareErasmus MC-University Medical CenterRotterdamThe Netherlands

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