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Clinical outcome of Guillain-Barré syndrome after prolonged mechanical ventilation
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  • Published on:
    Paradoxal increased incidence of post-traumatic stress disorder in non-mechanically ventilated Guillain-Barré syndrome patients: the role of resilience?
    • Loïc Le Guennec, Intensivist Hôpital de la Pitié-Salpêtrière - 75013 PARIS
    • Other Contributors:
      • Camille Tafani-de l Escalopier, Neurologist
      • Emmanuel Le Guen, Psychiatrist
      • Karine Viala, Neurologist
      • Benjamin Rohaut, Intensivist
      • Francis Bolgert, Intensivist
      • Sophie Demeret, Intensivist
      • Nicolas Weiss, Intensivist

    Dear Editor,

    We read with interest the study presented by Berg et al [1] that showed that prolonged mechanical ventilation (more than 2 months) in Guillain-Barre syndrome (GBS) was associated with poorer outcome and more residual deficits compared to non-ventilated GBS patients.

    We recently found very similar results in the same population of patients. Nevertheless, it should be precised that despite this, we could not found any difference in quality of life compared to the general French population [2]. Berg et al. also found that ventilated patients were less likely to have residual fatigue symptoms compared to non-ventilated GBS patients, respectively 20% versus 54% (p=0.007). Among 13 prolonged mechanically ventilated GBS, we could show that 22% of patients displayed DSM IV criteria for long-term post-traumatic stress disorder (PTSD) [2]. Since one of our main hypothesis was that PTSD symptoms were mainly related to the mechanical ventilation, we assessed long-term PTSD in 20 non-ventilated GBS patients (Table). Unexpectedly, 65% of these non-ventilated patients had PTSD as compared to 22% in the ventilated group found in our previous study (Table). As for fatigue, we would have expected a correlation between the severity of the disease (especially mechanical ventilation), and the incidence of PTSD.

    One explanation of these unexpected results could be that the acute stress induced by the temporary paralysis, the traumatic aspects of intubation an...

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    Conflict of Interest:
    None declared.