Intradermal thumbtack needling as an adjunctive therapy for sepsis-induced gastrointestinal dysfunction: A pilot randomized controlled trial

Sepsis-induced gastrointestinal dysfunction (GID) is common in critically ill patients, leading to impaired motility, feeding intolerance, and poor outcomes. Evidence for acupuncture-related neuromodulation remains limited. Intradermal thumbtack needling (ITN), a minimally invasive technique that provides continuous low-intensity stimulation, may serve as an adjunct in Intensive Care Unit (ICU), but its clinical effects remain unexamined. This study aims to assess the efficacy and safety of ITN in patients with sepsis-induced GID.

Sixty patients with sepsis-induced GID were randomly assigned to the conventional treatment (CT) group or ITN group. Both groups received standard therapies (ventilation, vasopressors, anti-infectives, fluid resuscitation, gastrointestinal mucosal protection, and prokinetics). The ITN group also received ITN at auricular and body acupoints for 7 days. Gastrointestinal function indicators (acute gastrointestinal injury [AGI] grade, gastric antrum motility index [MI], abdominal circumference, intra-abdominal pressure [IAP]), inflammatory markers, and severity scores were assessed before and after treatment. 28-day mortality, ICU length of stay and adverse events were assessed after treatment.

The ITN group showed greater improvement in AGI grade, abdominal circumference, and IAP (all P < 0.05). No significant differences were observed for MI, inflammatory markers, or severity scores (all P > 0.05). 28-day mortality and ICU length of stay did not differ significantly between groups. No ITN-related adverse events occurred. ITN may improve gastrointestinal parameters in sepsis-induced GID patients, but it did not significantly affect gastric motility, systemic inflammation, or global severity scores. Larger, controlled trials are needed to confirm its potential role as adjunctive therapy.