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Effect of bundling auricular acupressure and fluid restriction program on salivary flow rate and fluid control

Zohour Ibrahim Rashwan1, Marwa Mohamed Mahmoud Abdellah2, Ferial Moursi3

  • 1Pediatric Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

BMC Nursing
|July 2, 2025
PubMed

Insights

Auricular Acupressure (AA) combined with fluid restriction improved salivary flow and fluid adherence in children on hemodialysis (HD). This safe, cost-effective intervention helps manage thirst and improve patient compliance with fluid restrictions.

Area of Science:

  • Nephrology
  • Complementary Medicine
  • Pediatrics

Background:

  • Children undergoing hemodialysis (HD) often experience reduced salivary flow and xerostomia, leading to increased fluid intake and overload.
  • Auricular Acupressure (AA) stimulates the parasympathetic nervous system, potentially increasing salivary flow and reducing thirst.

Purpose of the Study:

  • To evaluate the combined effect of AA and a fluid restriction program on salivary flow rate in pediatric HD patients.
  • To assess the impact of this intervention bundle on adherence to fluid restrictions among these children.

Main Methods:

  • A single-blinded randomized controlled trial involving 60 children on HD at Alexandria University Children's Hospital.
  • Participants were randomized into a control group (fluid restriction program) and a study group (fluid restriction program plus AA sessions).
  • AA was administered on four specific acupoints over twelve sessions.

Main Results:

  • The study group showed significant improvements in subjective and objective measures of salivary flow rate, with salivation increasing from 33.3% to 86.7% (p<0.001).
  • Both groups improved fluid control adherence, but the study group demonstrated significantly better adherence (p<0.001 and p=0.047).
  • Significant differences were noted in swallowing difficulty (p=0.005), saliva rate (p=0.016), and dryness of mouth/lips (p<0.009).

Conclusions:

  • Bundling Auricular Acupressure with fluid restriction programs is an effective strategy to enhance salivary flow and fluid control adherence in pediatric HD patients.
  • This intervention offers a safe, cost-effective, and complementary approach for nurses to support patient compliance with fluid restriction regimens.
Abstract

Keywords:
AcupressureAuricularFluid controlHemodialysisSalivary excretionTherapeutic adherence and compliance

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