Treatment for BP fluctuations in Guillain Barre Syndrome
What is the appropriate management for the blood pressure fluctuations seen in Guillain Barre Syndrome.
Blood pressure fluctuations in Guillain Barre Syndrome are best monitored in a medical intensive care unit (ICU) setting.
Generally, it is recommended that spontaneous fluctuations in the blood pressure be treated only if symptoms are present or the target organs are at risk.
Treatment of the triggering factors, such as pain, is important.
Simple measures such as putting the patient in the Trendelenburg position and administration of intravenous (IV) fluids can be taken when hypotension is symptomatic.
Use of vasopressor drugs may be necessary, with extreme caution, because hypersensitivity responses are common.
If needed, use of short-acting agents such as dopamine or phenylephrine is recommended.
Treatment of hypertension also should be done with caution as there is a risk of exaggerated response due to innervation hypersensitivity and baroreflex failure.
If antihypertensive agents are used, it is best to use a low dose of hydralazine or angiotensin converting enzyme inhibitors in less severe cases and nicardipine or nitroprusside, with caution, in more severe cases.
