Comparison of mean hospital stay in intravenous Immunoglobulin vs Plasmapharesis in children with gullian-barre syndrome in a Tertiary Care PICU.

Abstract

Objective: To compare the mean hospital stay between intravenous immunoglobulin (IVIG) versus plasmapheresis in the management of children with Guillain-Barré syndrome (GBS). Study Design: Randomized Controlled Trial. Setting: Emergency and Paediatric Intensive Care Unit, Children’s Hospital and Institute of Child Health, Multan. Period: June 2021 to December 2021. Material & Methods: Children aged 5-12 years of either sex presenting with GBS with duration below ≤2 weeks were included. Baseline demographic data like age, gender and duration of GBS were noted. Subjects were randomly divided into 2 groups (30 in each group) by lottery method. In Group-A, IVIG was administered for five days while in Group-B, patients received a daily one-volume plasma exchange (PE) for five consecutive days. Outcome was noted in terms of hospital stay. Results: In a total of 60 patients, there were 35 (58.3%) were female and 25 (41.7%) male. The mean age was 8.28±2.06 years while 36 (60.0%) patients were aged between 9 to 12 years. The mean duration of disease was 12.89±4.01 days. Maternal educational status of 17 (28.3%) patients was illiterate. The mean length of hospital stay in Group-A and Group B were 30.06±8.76 days and 18.71±6.43 days respectively which was significantly less (p<0.001) among patients who were administered PE. Conclusion: When compared to IVIG, plasmapheresis reduced the duration of mean hospital stay and improved the recovery of children with GBS.