Rong Lai, Yanling Pu, Huiyu Feng, Haiyan Wang, Xunsha Sun, Li Feng, Cunzhou Shen, Yusheng Liu, Shengxian Yang, Hongyan Zhou
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Clinical outcomes, including duration of continuous mechanical ventilation (CMV), length of stay (LOS) in the ICU, total hospital stay, muscle strength recovery as measured by the Muscle Research Council (MRC) score, and Guillain–Barré Syndrome Disability Scale (GBS-DS) and days to unaided walking, were compared between the two groups.</p><p><b>Results:</b> The “zipper method” group exhibited significant improvements in clinical outcomes compared to the classic method group. Specifically, the duration of CMV was reduced to 17.67 days, the LOS in the ICU was 22.33 days, the mean days to hospital discharge were 40.67 days, and the MRC score at 1 month was 43.67 and at 2 months was 56.67. Furthermore, the GBS-DS score at 2 months posttreatment was 1.00 and the mean days to unaided walking were 80.6 days, indicating a marked reduction in disability.</p><p><b>Conclusion:</b> The “zipper method” offers a promising new approach for the treatment of severe GBS in adults, leading to faster recovery of muscle strength and shorter ICU stays and length of hospital stay. This treatment strategy has the potential to improve patient outcomes and reduce the burden of severe GBS on healthcare systems. Further research, including prospective studies and randomized controlled trials, is warranted to validate these findings and explore the broader applicability of the “zipper method” in adult GBS treatment.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2025 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/2772197","citationCount":"0","resultStr":"{\"title\":\"Zipper Method in the Treatment of Severe Guillain–Barré Syndrome in Adults\",\"authors\":\"Rong Lai, Yanling Pu, Huiyu Feng, Haiyan Wang, Xunsha Sun, Li Feng, Cunzhou Shen, Yusheng Liu, Shengxian Yang, Hongyan Zhou\",\"doi\":\"10.1155/ane/2772197\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><b>Objective:</b> This study was aimed at evaluating the efficacy of the “zipper method,” a novel treatment strategy combining alternating plasma exchange (PLEX) and intravenous immunoglobulin (IVIG) pulse therapy, in adult patients with severe Guillain–Barré syndrome (GBS) requiring mechanical ventilation.</p><p><b>Methods:</b> A retrospective analysis was conducted on seven adult patients diagnosed with severe GBS and treated with mechanical ventilation from June 2022 to August 2023. Three received the “zipper method” (alternating PLEX and IVIG pulse therapy), and the other four were treated with the classic method (PLEX followed by IVIG pulse therapy). Clinical outcomes, including duration of continuous mechanical ventilation (CMV), length of stay (LOS) in the ICU, total hospital stay, muscle strength recovery as measured by the Muscle Research Council (MRC) score, and Guillain–Barré Syndrome Disability Scale (GBS-DS) and days to unaided walking, were compared between the two groups.</p><p><b>Results:</b> The “zipper method” group exhibited significant improvements in clinical outcomes compared to the classic method group. Specifically, the duration of CMV was reduced to 17.67 days, the LOS in the ICU was 22.33 days, the mean days to hospital discharge were 40.67 days, and the MRC score at 1 month was 43.67 and at 2 months was 56.67. Furthermore, the GBS-DS score at 2 months posttreatment was 1.00 and the mean days to unaided walking were 80.6 days, indicating a marked reduction in disability.</p><p><b>Conclusion:</b> The “zipper method” offers a promising new approach for the treatment of severe GBS in adults, leading to faster recovery of muscle strength and shorter ICU stays and length of hospital stay. This treatment strategy has the potential to improve patient outcomes and reduce the burden of severe GBS on healthcare systems. 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Zipper Method in the Treatment of Severe Guillain–Barré Syndrome in Adults
Objective: This study was aimed at evaluating the efficacy of the “zipper method,” a novel treatment strategy combining alternating plasma exchange (PLEX) and intravenous immunoglobulin (IVIG) pulse therapy, in adult patients with severe Guillain–Barré syndrome (GBS) requiring mechanical ventilation.
Methods: A retrospective analysis was conducted on seven adult patients diagnosed with severe GBS and treated with mechanical ventilation from June 2022 to August 2023. Three received the “zipper method” (alternating PLEX and IVIG pulse therapy), and the other four were treated with the classic method (PLEX followed by IVIG pulse therapy). Clinical outcomes, including duration of continuous mechanical ventilation (CMV), length of stay (LOS) in the ICU, total hospital stay, muscle strength recovery as measured by the Muscle Research Council (MRC) score, and Guillain–Barré Syndrome Disability Scale (GBS-DS) and days to unaided walking, were compared between the two groups.
Results: The “zipper method” group exhibited significant improvements in clinical outcomes compared to the classic method group. Specifically, the duration of CMV was reduced to 17.67 days, the LOS in the ICU was 22.33 days, the mean days to hospital discharge were 40.67 days, and the MRC score at 1 month was 43.67 and at 2 months was 56.67. Furthermore, the GBS-DS score at 2 months posttreatment was 1.00 and the mean days to unaided walking were 80.6 days, indicating a marked reduction in disability.
Conclusion: The “zipper method” offers a promising new approach for the treatment of severe GBS in adults, leading to faster recovery of muscle strength and shorter ICU stays and length of hospital stay. This treatment strategy has the potential to improve patient outcomes and reduce the burden of severe GBS on healthcare systems. Further research, including prospective studies and randomized controlled trials, is warranted to validate these findings and explore the broader applicability of the “zipper method” in adult GBS treatment.
期刊介绍：
Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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