A Quasi-Experimental Trial of Daily Versus Alternate-DayPlasmapheresis in the Management of Guillain-Barré Syndrome in aTertiary Neurology Center

Authors

Abstract

Objectives: To evaluate clinical outcomes, recovery trajectory, and operational advantages of consecutive-day versus alternate-day plasmapheresis schedules in patients with Guillain–Barré syndrome (GBS) managed in a high-volume public neurology ward.

Methods

This quasi-experimental study enrolled 80 adults meeting Brighton Criteria levels 1–3. Participants were allocated non-randomly into two equal groups receiving either consecutive-day or alternate-day plasmapheresis, five sessions each. Primary outcomes included improvement on the Hughes Disability Scale (HDS) at four weeks and length of hospitalization. Secondary outcomes included time to ambulation, ventilator requirement, complications, and estimated system-level cost reduction. Statistical analysis used chi-square and t-tests with significance at p<0.05.

Results

  Neurological improvement at four weeks did not differ significantly between the daily and alternate-day groups (72.5% vs. 75%; p=0.78). However, consecutive-day therapy significantly reduced length of hospital stay (9.2±2.1 vs. 14.8±3.4 days; p<0.001) and enabled earlier ambulation (p=0.03). Ventilation needs and complication rates were comparable. Estimated resource utilization showed approximately a 21% reduction in system expenditure with the daily regimen.

Conclusion

 Daily plasmapheresis offers clinical outcomes equivalent to alternate-day therapy while markedly decreasing hospital stay and resource consumption. In overburdened public-sector hospitals, a consecutive-day protocol provides a more efficient and practical treatment strategy without compromising patient safety.

Keywords:

Guillain–Barré syndrome, plasmapheresis, quasi-experimental study

Published

2026/03/04

Issue

Vol. Volume 7-issue 1

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