Therapeutic Applications of Neuromuscular Electrical Stimulation in Critical Care Patients

Neuromuscular Electrical Stimulation (NMES) is commonly used by physiotherapists for pain relief, stimulation of denervated or disused muscles, and the promotion of wound healing.  The purpose of this review is to discus the applications of NMES in Intensive Care Unit (ICU) patients according to the current research evidence. The first application is the neuromuscular electrical stimulation (NMES) in  ICU acquired weakness with research evidence indicating significant benefits such as preservation of  muscle mass, prevention of  polyneuromyopathy and improvement of muscle performance. Secondly, NMES has been proved to be effective in preventing pressure ulcers and accelerating wound healing through mechanisms which are clearly demonstrated by many experimental and clinical studies. However, very few studies have examined the effect of E.S. in pressure ulcers of long term hospitalized ICU patients. Lastly, NMES in ICU can be applied in the form of functional electrical stimulation (FES), a well known technique used to mobilize patients with permanent neurological deficits such as stroke and spinal cord injury. Current evidence in this area is reviewed and future research is proposed

Emerging therapies and respiratory infections: focus on the impact of immunosuppressants and immunotherapies

Host defences to infection are based upon an integrated system of physical and biochemical barriers, innate and adaptive immunity. Weakness in any of these defensive elements leads to increased susceptibility to specific pathogens. Understanding how medical therapies disrupt host defences is key to the successful prevention, diagnosis and management of respiratory infection in the immunocompromised host