☝️
اطلعوا علشان تفهم اكثر وربما أجابتك
تكن مجمعة من اكثر من مصدر وتختصر
على حسب ما أنت تراه مناسب.
بالتوفيق 💐
اطلعوا علشان تفهم اكثر وربما أجابتك
تكن مجمعة من اكثر من مصدر وتختصر
على حسب ما أنت تراه مناسب.
بالتوفيق 💐
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Forwarded from فَهْمٓــــــيٌ'
Management of Guillain barre syndrome...
a. Immediate management of patients with AIDP focuses
on close monitoring and supportive care
1) Serial maximal respiratory pressures and forced vital
capacities (FVC)2) Mechanical ventilation and intensive care for precipitous decrease in any measure or low respiratory values
(FVC <20 mL/kg, maximal inspiratory pressure <30
mm Hg, or maximal expiratory pressure <40 mm Hg)
3) Management of autonomic instability: labile blood
pressure, cardiac arrhythmias (cardiac monitoring
required), urine retention, and ileus
4) Management of pain (very common symptom in
acute and plateau phases of care): refractory pain may
be treated with antiepileptic medications; short-term
narcotics may be necessary
b. Management of disease course: immunomodulation
1) Corticosteroids have never been conclusively shown
to help shorten disease course or minimize morbidity
2) Intravenous immunoglobulin and plasmapheresis are
likely equally effective in mitigating disease severity
and should be instituted early
..Both intravenous immunoglobulin (IVIG; 0.4 g/kg/day for
5 days) and plasmapheresis (five to six exchanges over
1–2 weeks) appear equally effective when given within the
first 2 weeks after onset. Combination therapy consisting
of both does not provide additional benefit. Plasmapheresis
may be precluded in hemodynamically unstable patients.
These measures generally increase the pace of recovery,
although their effects on the severity of the disease, the risk of
respiratory and autonomic dysfunction, and ultimate disability are less clear.
a. Immediate management of patients with AIDP focuses
on close monitoring and supportive care
1) Serial maximal respiratory pressures and forced vital
capacities (FVC)2) Mechanical ventilation and intensive care for precipitous decrease in any measure or low respiratory values
(FVC <20 mL/kg, maximal inspiratory pressure <30
mm Hg, or maximal expiratory pressure <40 mm Hg)
3) Management of autonomic instability: labile blood
pressure, cardiac arrhythmias (cardiac monitoring
required), urine retention, and ileus
4) Management of pain (very common symptom in
acute and plateau phases of care): refractory pain may
be treated with antiepileptic medications; short-term
narcotics may be necessary
b. Management of disease course: immunomodulation
1) Corticosteroids have never been conclusively shown
to help shorten disease course or minimize morbidity
2) Intravenous immunoglobulin and plasmapheresis are
likely equally effective in mitigating disease severity
and should be instituted early
..Both intravenous immunoglobulin (IVIG; 0.4 g/kg/day for
5 days) and plasmapheresis (five to six exchanges over
1–2 weeks) appear equally effective when given within the
first 2 weeks after onset. Combination therapy consisting
of both does not provide additional benefit. Plasmapheresis
may be precluded in hemodynamically unstable patients.
These measures generally increase the pace of recovery,
although their effects on the severity of the disease, the risk of
respiratory and autonomic dysfunction, and ultimate disability are less clear.
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