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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.
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.
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 mediators released in response to injury, surgery, infection, and hemorrhage can lead to intestinal mucosal damage, translocation of gut microbiota4, loss of barrier function5, compromised immune defense system6, and secretory dysfunction7. The mortality rate increases with the severity of AGI, significantly surpassing that of non-AGI patients8.
While early bowel rest and traditional treatment plans aimed at increasing tissue perfusion and oxygen delivery are widely acknowledged, their effectiveness remains a subject of debate2. There is currently no agreed-upon nutritional program for patients with severe AGI, which has a significant impact on patients' clinical outcomes. Therefore, alternative treatments must be explored to manage this condition. Acupuncture, a traditional Chinese medicine practice, has a rich history and extensive experience in treating serious illnesses. By controlling gastrointestinal motility, protecting the gastric mucosa, and reducing visceral sensitivity, acupuncture has shown potential in treating various digestive system disorders9. Numerous studies have demonstrated the safe and effective recovery of gastrointestinal function through acupuncture therapy10,11,12.
Currently, few methods are available for monitoring gastrointestinal dysfunction in critically ill individuals13. Clinical assessment, although commonly used and often combined with gastric residual volume (GRV) measurement, is imperfect in evaluating overall GI function14 and lacks standardization in AGI investigations of critically ill patients. Recent research has shown that ultrasound (US) can facilitate quantification of tissue perfusion (US Doppler), intestinal peristalsis, colon diameter, and gastric emptying. Both GRV measurement and estimations based on CT imaging and gastric antrum diameter have demonstrated correlations15.
This study aims to validate the therapeutic impact of acupuncture in AGI patients based on previous research. The article provides a detailed account of the effective use of acupuncture in treating patients with severe AGI.
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
2. Patient grouping
3. Interventions
4. Ultrasonic analysis
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...
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...
The authors declare that they have no competing interests.
This study was supported by Science and Technology Development Fund of Hospital of Chengdu University of Traditional Chinese Medicine (No: 20KL-10).
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 |
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