Acupuncture in critically ill patients improves delayed gastric emptying: a randomized controlled trial

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Integrative Medicine

Background:

• Malnutrition is a significant issue in critically ill patients, prolonging hospital stays and increasing morbidity.
• Early enteral nutrition is crucial, but delayed gastric emptying and reflux complicate its administration in ICUs.
• Acupuncture has shown efficacy in managing nausea and vomiting, suggesting potential for improving gastric motility.

Purpose of the Study:

• To evaluate the efficacy of acupuncture in improving gastric emptying compared to standard promotility drugs in critically ill patients on enteral feeding.
• To assess acupoint stimulation's effectiveness in managing delayed gastric emptying, a common complication in intensive care unit (ICU) patients.

Main Methods:

• A prospective randomized study involving 30 mechanically ventilated neurosurgical ICU patients with delayed gastric emptying (GRV >500 mL for ≥2 days).
• Patients were assigned to either acupoint stimulation (ASG) using transcutaneous electrical stimulation at Neiguan (PC-6) or conventional promotility drug treatment (DTG) for 6 days.
• Successful treatment was defined as achieving a gastric residual volume (GRV) <200 mL per 24 hours.

Main Results:

• The acupoint stimulation group (ASG) showed a higher success rate (80%) in achieving feeding tolerance compared to the drug treatment group (DTG) (60%).
• On day 1, ASG demonstrated a significant decrease in GRV (970 to 346 mL), while DTG showed an increase (903 to 1040 mL).
• Feeding balance improved significantly in more ASG patients (14/15) than DTG patients (7/15), with higher mean feeding balance in the ASG group on day 1.

Conclusions:

• Acupoint stimulation at Neiguan (PC-6) is a more effective treatment for delayed gastric emptying in critically ill patients than standard promotility medications.
• This acupuncture protocol offers a convenient, inexpensive, and low-side-effect option for preventing and treating malnutrition in the critical care setting.
• The findings support the integration of acupuncture as an adjunctive therapy to improve nutritional support and patient outcomes in ICUs.