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Published in:

01-10-2016

Respiratory Muscle Assessment in Acute Guillain–Barré Syndrome

Authors: S. Walterspacher, A. Kirchberger, J. Lambeck, D. J. Walker, A. Schwörer, W. D. Niesen, W. Windisch, F. Hamzei, H. J. Kabitz

Published in: Lung | Issue 5/2016

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: PI_max/PE_max, 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, PI_max, 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.

Green DM (2005) Weakness in the ICU: Guillain Barre Syndrome, myasthenia gravis, and critical illness polyneuropathy/myopathy. Neurologist 11:338–347. doi:10.1097/01.nrl.0000163784.17602.57 CrossRefPubMed

Lawn ND, Fletcher DD, Henderson RD et al (2001) Anticipating mechanical ventilation in Guillain-Barré syndrome. Arch Neurol 58:893–898. doi:10.1001/archneur.58.6.893 CrossRefPubMed

Mehta S (2006) Neuromuscular disease causing acute respiratory failure. Respir Care 51:1016–1023PubMed

Durand M-C, Porcher R, Orlikowski D et al (2006) Clinical and electrophysiological predictors of respiratory failure in Guillain–Barré syndrome: a prospective study. Lancet Neurol 5:1021–1028. doi:10.1016/S1474-4422(06)70603-2 CrossRefPubMed

van Koningsveld R, Steyerberg EW, Hughes RA et al (2007) A clinical prognostic scoring system for Guillain–Barré syndrome. Lancet Neurol 6:589–594. doi:10.1016/S1474-4422(07)70130-8 CrossRefPubMed

Kleyweg RP, Van Der Meché FGA, Schmitz PIM (1991) Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain–Barré syndrome. Muscle Nerve 14:1103–1109. doi:10.1002/mus.880141111 CrossRefPubMed

Rochester DF, Arora NS (1983) Respiratory muscle failure. Med Clin North Am 67:573–597CrossRefPubMed

American Thoracic Society (2002) ATS/ERS statement on respiratory muscle testing. Am J Respir Crit Care Med 166:518–624. doi:10.1164/rccm.166.4.518 CrossRef

WMA (2013) WMA Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects. http://www.wma.net/en/30publications/10policies/b3/. Accessed 2 Jan 2014

10.

Diener H-C (2012) Leitlinien für Diagnostik und Therapie in der Neurologie, 5., vollständig überarbeitete Auflage. Thieme, Stuttgart

11.

Wanger J (2005) Standardisation of the measurement of lung volumes. Eur Respir J 26:511–522. doi:10.1183/09031936.05.00035005 CrossRefPubMed

12.

Miller MR (2005) Standardisation of spirometry. Eur Respir J 26:319–338. doi:10.1183/09031936.05.00034805 CrossRefPubMed

13.

Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377–381PubMed

14.

Kabitz H-J, Windisch W (2007) Diagnostik der Atemmuskelfunktion: state of the Art. Pneumologie 61:582–587. doi:10.1055/s-2007-980080 CrossRefPubMed

15.

Windisch W, Kabitz HJ, Sorichter S (2005) Influence of different trigger techniques on twitch mouth pressure during bilateral anterior magnetic phrenic nerve stimulation. CHEST J 128:190–195CrossRef

16.

Durand M-C, Lofaso F, Lefaucheur J-P et al (2003) Electrophysiology to predict mechanical ventilation in Guillain–Barré syndrome. Eur J Neurol 10:39–44. doi:10.1046/j.1468-1331.2003.00505.x CrossRefPubMed

17.

Zifko U, Chen R, Remtulla H et al (1996) Respiratory electrophysiological studies in Guillain–Barré syndrome. J Neurol Neurosurg Psychiatry 60:191–194. doi:10.1136/jnnp.60.2.191 CrossRefPubMedPubMedCentral

18.

Steier J, Kaul S, Seymour J et al (2007) The value of multiple tests of respiratory muscle strength. Thorax 62:975–980. doi:10.1136/thx.2006.072884 CrossRefPubMedPubMedCentral

19.

Polkey MI, Moxham J (2001) Clinical aspects of respiratory muscle dysfunction in the critically ill*. Chest 119:926–939. doi:10.1378/chest.119.3.926 CrossRefPubMed

20.

Terzi N, Orlikowski D, Fermanian C et al (2008) Measuring inspiratory muscle strength in neuromuscular disease: one test or two? Eur Respir J 31:93–98. doi:10.1183/09031936.00094707 CrossRefPubMed

21.

Fitting JW, Paillex R, Hirt L et al (1999) Sniff nasal pressure: a sensitive respiratory test to assess progression of amyotrophic lateral sclerosis. Ann Neurol 46:887–893CrossRefPubMed

22.

Prigent H, Orlikowski D, Letilly N et al (2012) Vital capacity versus maximal inspiratory pressure in patients with Guillain-Barré Syndrome and myasthenia gravis. Neurocrit Care 17:236–239. doi:10.1007/s12028-011-9575-y CrossRefPubMed

23.

Orlikowski D, Prigent H, Sharshar T et al (2004) Respiratory dysfunction in guillain-barré syndrome. Neurocrit Care 1:415–422. doi:10.1385/NCC:1:4:415 CrossRefPubMed

24.

Troyer AD, Borenstein S, Cordier R (1980) Analysis of lung volume restriction in patients with respiratory muscle weakness. Thorax 35:603–610. doi:10.1136/thx.35.8.603 CrossRefPubMedPubMedCentral

25.

Miller JM, Moxham J, Green M (1985) The maximal sniff in the assessment of diaphragm function in man. Clin Sci 69:91–96. doi:10.1042/cs0690091 CrossRefPubMed

26.

Prigent H, Lejaille M, Falaize L et al (2004) Assessing inspiratory muscle strength by sniff nasal inspiratory pressure. Neurocrit Care 1:475–478. doi:10.1385/NCC:1:4:475 CrossRefPubMed

27.

Fitting J-W (2006) Sniff nasal inspiratory pressure: simple or too simple? Eur Respir J 27:881–883. doi:10.1183/09031936.06.00007906 PubMed

28.

Stefanutti D, Benoist M-R, Scheinmann P et al (2000) Usefulness of sniff nasal pressure in patients with neuromuscular or skeletal disorders. Am J Respir Crit Care Med 162:1507–1511. doi:10.1164/ajrccm.162.4.9910034 CrossRefPubMed

29.

Capozzo R, Quaranta VN, Pellegrini F et al (2014) Sniff nasal inspiratory pressure as a prognostic factor of tracheostomy or death in amyotrophic lateral sclerosis. J Neurol 262:593–603. doi:10.1007/s00415-014-7613-3 CrossRefPubMed

30.

Lyall RA, Donaldson N, Polkey MI et al (2001) Respiratory muscle strength and ventilatory failure in amyotrophic lateral sclerosis. Brain 124:2000–2013. doi:10.1093/brain/124.10.2000 CrossRefPubMed

31.

Chaudri MB, Liu C, Watson L et al (2000) Sniff nasal inspiratory pressure as a marker of respiratory function in motor neuron disease. Eur Respir J 15:539–542CrossRefPubMed

32.

Chevrolet JC, Deléamont P (1991) Repeated vital capacity measurements as predictive parameters for mechanical ventilation need and weaning success in the Guillain–Barré syndrome. Am Rev Respir Dis 144:814–818. doi:10.1164/ajrccm/144.4.814 CrossRefPubMed

33.

Rieder P, Louis M, Jolliet P, Chevrolet JC (1995) The repeated measurement of vital capacity is a poor predictor of the need for mechanical ventilation in myasthenia gravis. Intensive Care Med 21:663–668CrossRefPubMed

34.

Walgaard C, Lingsma HF, Ruts L et al (2010) Prediction of respiratory insufficiency in Guillain–Barré syndrome. Ann Neurol 67:781–787. doi:10.1002/ana.21976 PubMed

35.

Hart N, Polkey MI, Sharshar T et al (2003) Limitations of sniff nasal pressure in patients with severe neuromuscular weakness. J Neurol Neurosurg Psychiatry 74:1685–1687. doi:10.1136/jnnp.74.12.1685 CrossRefPubMedPubMedCentral

36.

Bourke SC (2014) Respiratory involvement in neuromuscular disease. Clin Med 14:72–75. doi:10.7861/clinmedicine.14-1-72 CrossRef

Title: Respiratory Muscle Assessment in Acute Guillain–Barré Syndrome
Authors: S. Walterspacher
A. Kirchberger
J. Lambeck
D. J. Walker
A. Schwörer
W. D. Niesen
W. Windisch
F. Hamzei
H. J. Kabitz
Publication date: 01-10-2016
Publisher: Springer US
Published in: Lung / Issue 5/2016
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-016-9929-5

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