Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Nov 4, 2016; 5(4): 201-203
Published online Nov 4, 2016. doi: 10.5492/wjccm.v5.i4.201
New avenues for reducing intensive care needs in patients with chronic spinal cord injury
Pierre A Guertin
Pierre A Guertin, Department of Psychiatry and Neurosciences, Laval University, Québec City, QC G1V 0A6, Canada
Pierre A Guertin, Laval University Medical Center (CHU de Québec - CHUL), Québec City, QC G1V 4G2, Canada
Author contributions: Guertin PA solely contributed to all aspects of this editorial paper.
Conflict-of-interest statement: The author is also president and chief executive officer of Nordic Life Science Pipeline.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pierre A Guertin, PhD, Professor, Laval University Medical Center (CHU de Québec - CHUL), 2705 Laurier Boulevard, RC-9800 (Neuroscience), Québec City, QC G1V 4G2, Canada. pierre.guertin@crchul.ulaval.ca
Telephone: +1-418-5254444 Fax: +1-418-6542753
Received: March 24, 2016
Peer-review started: March 24, 2016
First decision: May 16, 2016
Revised: July 5, 2016
Accepted: August 11, 2016
Article in press: August 15, 2016
Published online: November 4, 2016
Processing time: 224 Days and 11 Hours
Abstract

Relatively soon after their accident, patients suffering a spinal cord injury (SCI) begin generally experiencing the development of significant, often life-threatening secondary complications. Many of which are associated with chronic physical inactivity-related immune function problems and increasing susceptibility to infection that repeatedly requires intensive care treatment. Therapies capable of repairing the spinal cord or restoring ambulation would normally prevent many of these problems but, as of now, there is no cure for SCI. Thus, management strategies and antibiotics remain the standard of care although antimicrobial resistance constitutes a significant challenge for patients with chronic SCI facing recurrent infections of the urinary tract and respiratory systems. Identifying alternative therapies capable of safe and potent actions upon these serious health concerns should therefore be considered a priority. This editorial presents some of the novel approaches currently in development for the prevention of specific infections after SCI. Among them, brain-permeable small molecule therapeutics acting centrally on spinal cord circuits that can augment respiratory capabilities or bladder functions. If eventually approved by regulatory authorities, some of these new avenues may potentially become clinically-relevant therapies capable of indirectly preventing the occurrence and/or severity of these life-threatening complications in people with paraplegic or tetraplegic injuries.

Keywords: Prevention of intensive care problems; Quality of care; Temporary recovery of vital functions; Micturition; Spinal networks; Central pattern generators

Core tip: This editorial is one of the first articles to describe clearly the existence of an urgent medical need for new pharmacological products aimed at providing non-invasive solutions for spinal cord injury patients suffering chronically of urinary tract infection or pneumonia. Drugs capable of activating temporarily on demand activity in specific central networks of neurons that control respiration or micturition are of particular interest.