Acupuncture as a Therapeutic Intervention for Acute Gastrointestinal Injury (AGI): A Preliminary Study

Summary

Acute gastrointestinal injury (AGI) is a prevalent occurrence in intensive care units and has been linked to unfavorable patient outcomes. The current approaches focus on addressing the primary disease and providing symptomatic relief. The protocol here demonstrates the implementation of acupuncture as a therapeutic intervention for AGI.

Abstract

Acute gastrointestinal injury (AGI) is a significant factor contributing to increased mortality in patients receiving intensive care unit (ICU) care. Traditional Chinese medicine's acupuncture techniques offer an alternative approach to treating digestive disorders by controlling gastrointestinal secretion, improving gastrointestinal motility, and minimizing side effects. Transabdominal intestinal ultrasonography has proven effective in assessing gastrointestinal injury in critically ill patients. This study aims to evaluate the therapeutic effect of acupuncture in AGI patients using ultrasound. The main steps of the study include the syndrome-based selection of appropriate acupuncture points, including Hegu (LI4), Zhongwan (CV 12), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), and Xiajuxu (ST 39), followed by a 30 min Deqi acupuncture session once a day for 1 week. The treatment's effectiveness is assessed by an experienced physician using abdominal gastrointestinal ultrasonography. This article provides a detailed account of how to standardize the use of acupuncture in treating gastrointestinal dysfunction in critically ill patients.

Introduction

Acute gastrointestinal injury (AGI) refers to the malfunctioning of the gastrointestinal (GI) tract in critically ill patients due to their acute illness¹. It is a significant contributor to acquired frailty, extended hospital stays, and higher fatality rates among patients receiving intensive care unit (ICU) care². Approximately 60% of ICU patients experience symptoms of AGI, and 40% develop AGI, with severe cases having a mortality rate of up to 33%³. AGI can arise or worsen as a result of multiple organ dysfunction syndrome (MODS) and systemic inflammatory response syndrome (SIRS). Inflammatory....

Protocol

Eligible volunteers provide written, informed consent prior to participating in the research. The protocol was carried out in accordance with the Declaration of Helsinki, approved by the Hospital of Chengdu University of Traditional Chinese Medicine's Medical Ethics Committee (ethics approval number: 2022KL-006).

1. Screening and diagnostics

1. Screen patients according to the inclusion and exclusion criteria with AGI in the initial phase of this study. Use the following diagnostic standards; class II-III on AGI as of the 2012 European Society for Intensive Care Medicine (ESICM)¹.
   ....

Results

General information
In this clinical study, a total of 15 patients were observed, and ultimately, 10 patients successfully completed the 7-day trial process, with 5 patients in the treatment group and 5 patients in the control group. Comprehensive trial data were collected from all patients and included in the final analysis. The mean age of the enrolled patients was 60.50 years, with 3 males in each group.

To compare between the treatment group and the control group, an i.......

Discussion

Critically ill patients often experience acute gastrointestinal injury (AGI), which encompasses delayed gastric emptying, abnormal intestinal motility patterns, and compromised intestinal barrier integrity¹⁶. The grading of AGI assists in identifying the severity of gastrointestinal dysfunction and serves as a strong predictor of mortality among severely ill patients¹⁷. Transabdominal intestinal ultrasonography has been established as an effective me.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Cotton swab	Chengdu Zhongxin Sanitary Materials Co., Ltd.	20220415	For hemostasis
Iodophor cotton swab	Zhejiang Baikal Health Technology Co., Ltd.	20220601	For disinfection of acupuncture points
Portable Color Doppler Ultrasound System	Mindray	M9	Assess gastrointestinal function.
Sterile Acupuncture Needles	Changchun Aikang Medical Equipment Corporation	20172270314	For acupuncture
TM-100 medical ultrasonic couplant	Tianjin Xiyuan Temple Factory	20190618	For air isolation during ultrasonography