Prospective Study on Swallowing/Breathing Interactions in Severe Guillain Barre Syndrome. (DGVSB)

To estimate, in a longitudinal and not invasive way, in patients with SGB at respiratory risk, the function of respiratory muscles and that of the upper airways muscles by investigating the force of the tongue, the gulp, and the breath during the sleep to be able to detect bulbar impairment and establish correlations enter the various parameters to estimate better the interactions between the dysfunction of the respiratory muscles and that upper airways muscles and so determine the risk acute respiratory failure.

Study Overview

• Status: Completed
• Conditions: Respiratory Failure; Tetraplegia

Detailed Description

Context: the syndrome of Guillain Barré ( SGB) is the first causes of extensive paralysis of medical origin in industrial nations. A third of these patients going to require mechanical invasive ventilation during their stay in ICU. This population of ventilated presents the strongest risk of infectious respiratory patient complications and death. The respiratory impairment is a progressive weakness of inspiratory and expiratory muscles. The monitoring of the respiratory muscular infringement is usually made by the repeated measure of vital capacity and the maximal respiratory pressures. The occurrence of bulbar impairment is an aggravating element entailing dysfunction of the upper airways muscles detected often late in front of aspiration. Besides the arisen of sleep apneas was never sought in this context. This dysfunction of the upper airways muscles could be more detected prematurely by objectivizes measures of them performances.

Method: longitudinal observational and in a one center study. The respiratory impairment will be estimated by the measure of the vital capacity, maximal respiratory pressures and of the debit of cough. The existence of a bulbar infringement will be sought by the measure of the force of the tongue, an objective measure of gulp performances and a polysomnographic recording.

Criterion of selection: patient admitted in ICU with GBS and respiratory risk. Number of patients, centre: 40 patients admitted in the intensive care unit of the hospital RAYMOND POINCARE and 20 controls.

Duration of the study: 24 months Perspectives: better anticipate acute respiratory failure and the indication of an invasive ventilation.

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• France
  • Garches, France, 92380
    • Hôpital Raymond Poincaré

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patient admitted in ICU with GBS and respiratory risk

Description

Inclusion Criteria:

• Guillain Barré Syndrome

• Presenting a risk of mechanical ventilation(breakdown): presence of 2 among the following 5 criteria

  • Deficit evolving for less than 7 days
  • Impossibility to stand up
  • Impossibility to raise the head
  • ineffective Cough
  • Vital capacity< 60 %

Exclusion Criteria:

• MAJOR confusions of gulp (spontaneous) at admittance
• Respiratory distress syndrome and intubation at admission buccal dental lesions
• Not membership to a regime of Social Security (beneficiary or legal successor)
• Patient under guardianship or custody

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
GBS PATIENT
CONTROL

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Correlation between respiratory failure and bulbar dysfunction during ICU stay	24 MONTHS

Secondary Outcome Measures

Outcome Measure	Time Frame
Number of aspiration pneumonia	24 MONTHS

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Investigators: Principal Investigator: David Orlikowski, PH, Assistance Publique - Hôpitaux de Paris

Study record dates

Study Major Dates

• Study Start: March 1, 2008
• Primary Completion (Actual): July 1, 2012
• Study Completion (Actual): July 1, 2012

Study Registration Dates

• First Submitted: November 30, 2009
• First Submitted That Met QC Criteria: November 30, 2009
• First Posted (Estimate): December 2, 2009

Study Record Updates

• Last Update Posted (Estimate): September 16, 2014
• Last Update Submitted That Met QC Criteria: September 15, 2014
• Last Verified: February 1, 2011

More Information

Terms related to this study

• Keywords: Respiratory failure; Swallowing disorders; Guillain Barré syndrome
• Additional Relevant MeSH Terms: Nervous System Diseases; Respiratory Tract Diseases; Immune System Diseases; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Autoimmune Diseases; Respiration Disorders; Neurologic Manifestations; Neuromuscular Diseases; Peripheral Nervous System Diseases; Paralysis; Polyradiculoneuropathy; Polyneuropathies; Respiratory Insufficiency; Quadriplegia; Guillain-Barre Syndrome
• Other Study ID Numbers: P061016 -CRC 06040