Acupuncture reduces mechanical ventilation time in critically ill patients: A systematic review and meta-analysis of randomized control trials

Eyal Ben-Arie; Peter Karl Mayer; Bernice Jeanne Lottering; Wen-Chao Ho; Yu-Chen Lee; Pei-Yu Kao

doi:10.1016/j.explore.2023.11.007

Acupuncture reduces mechanical ventilation time in critically ill patients: A systematic review and meta-analysis of randomized control trials

Explore (NY). 2023 Nov 25:S1550-8307(23)00266-5. doi: 10.1016/j.explore.2023.11.007. Online ahead of print.

Authors

Eyal Ben-Arie¹, Peter Karl Mayer², Bernice Jeanne Lottering¹, Wen-Chao Ho³, Yu-Chen Lee⁴, Pei-Yu Kao⁵

Affiliations

¹ Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
² International Master Program in Acupuncture, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
³ Department of Public Health, China Medical University, Taichung 40402, Taiwan.
⁴ Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; Department of Acupuncture, China Medical University Hospital, Taichung 40402, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan. Electronic address: 005167@tool.caaumed.org.tw.
⁵ Surgical Intensive Care Unit, China Medical University Hospital, Taichung 40402, Taiwan; Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung 40402, Taiwan; Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan. Electronic address: ludouto@gmail.com.

PMID: 38065826
DOI: 10.1016/j.explore.2023.11.007

Abstract

Background: Mechanical Ventilation (MV) is an essential life support machine, frequently utilized in an Intensive Care Unit (ICU). Recently, a growing number of clinical trials have investigated the effect of acupuncture treatment on MV outcomes.

Objectives: This study investigated the safety and efficacy of acupuncture treatment for critically ill patients under MV.

Methods: In this systematic review and meta-analysis of randomized controlled trials, the efficacy of acupuncture related interventions was compared to routine ICU treatments, and sham/control acupuncture as control interventions applied to ICU patients undergoing MV. The databases of PubMed, Cochrane Library, and Web of Science were extensively searched in the month of April 2022. The primary outcome measurements were defined as total MV time, ICU length of stay, and mortality. The Cochrane Collaboration risk of bias tool was employed to analyze the severity of bias. The meta-analysis was conducted using Review Manager 5.3 software. The quality of evidence was evaluated according to the GRADE approach.

Results: A total of 10 clinical trials were included in this investigation. When comparing the performance of acupuncture-related interventions to that of the reported control interventions, the results of the meta-analysis revealed a significant reduction in the total number of MV days as well as the duration of ICU length of stay following acupuncture treatment (MD -2.06 [-3.33, -0.79] P = 0.001, I² = 55 %, MD-1.26 [-2.00, -0.53] P = 0.0008, I² = 77 %, respectively). A reduction in the total mortality was similarly observed (RR = 0.67 [0.47, 0.94] P = 0.02, I² = 0 %).

Conclusion: This systematic review and meta-analysis identified a noteworthy reduction in the total MV days, time spent in the ICU, as well as the total mortality following acupuncture related interventions. However, the small sample size, risk of bias and existing heterogeneity should be taken into consideration. The results of this study are promising and further investigations in this field are warranted.

Keywords: Acupuncture; Electro acupuncture; ICU; Intensive Care Unit; Mechanical ventilation; Meta-analysis.

Publication types

Review