The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

EndNote Style
Acupuncture in critically ill patients
Acupuncture has been used in Eastern medicine for thousands of years for a variety of conditions and illnesses. However, there is very little literature on the use of acupuncture in intensive care. In this review, we examine the role of acupuncture in intensive care, pain, stress, anxiety, sleep quality, treatment support, reduction of side effects, respiratory problems, circulatory shock, immune system and nutritional support, and functional recovery after critical illness.

1. Lu AP, Jia HW, Xiao C, Lu QP. Theory of traditional Chinesemedicine and therapeutic method of diseases. World J Gastroenterol.2004;10(3):1854.doi: 10.3748/wjg.v10.i13.1854
2. Lu A, Jiang M, Zhang C, Chan K. An integrative approach of linkingtraditional Chinese medicine pattern classification and biomedicinediagnosis. JEthnopharmacol.2012;141:549-556.doi: 10.1016/j.jep.2011.08.045
3. Xutian S, Zhang J, Louise W. New exploration and understandingof traditional Chinese medicine. Am J Chin Med.2009;37(03):411-426.doi: 10.1142/S0192415X09006941
4. Xue CCL, Zhang AL, Greenwood KM, Lin V, Story DF. TraditionalChinese medicine: an update on clinical evidence. J Alternative ComplMed. 2010;16(3):301-312. doi: 10.1089/acm.2009.0293
5. Unsal N, Akcaboy ZN, Soyal OB, Akcaboy EY, Mutlu NM, GogusN. Effectiveness of intraoperative laser acupuncture combined withantiemetic drugs for prevention of postoperative nausea and vomiting.J Altern Complement Med. 2020;26(1):67-71. doi: 10.1089/acm.2019.0181
6. Carlos L, Cruz LAP da, Leopoldo VC, Campos FR de, Almeida AM de,RC de CP Silveira. Effectiveness of traditional Chinese acupunctureversus sham acupuncture: a systematic review. Rev Lat Am Enfermagem.2016;24:e2762. doi: 10.1590/1518-8345.0647.2762
7. Yeh GY, Horwitz R. Integrative medicine for respiratory conditions:asthma and chronic obstructive pulmonary disease. Med ClinNorthAm. 2017;101(5):325-941. doi: 10.1016/j.mcna.2017.04.008
8. Matsumoto-Miyazaki J, Ushikoshi H, Suzuki K, et al. Efficacy ofacupuncture treatment for improving the respiratory status inpatients receiving prolonged mechanical ventilation in intensive careunits: a retrospective observational study. J Alternative Compl Med.2018;24(11):1076-1084. doi: 10.1089/acm.2017.0365
9. Patil S, Sen S, Bral M, et al. The role of acupuncture in painmanagement. Curr Pain Headache Rep. 2016;20(4):22. doi: 10.1007/s11916-016-0552-1
10. Yuan SC, Cao WJ, Huang Y, Hua SY, Zhou YH, Cai R. Effect ofacupuncture on analgesia and sedation in elderly patients withsevere pneumonia during invasive mechanical ventilation. ZhongguoZhen Jiu=Chinese Acupunct Moxibust. 2021;41(9):971-978. doi:10.13703/j.0255-2930.20200903-k0004
11. Lee A, Done ML. Stimulation of the wrist acupuncture point P6 forpreventing postoperative nausea and vomiting. Cochrane DatabaseSyst Rev. 2004;(3):CD003281. doi: 10.1002/14651858.CD003281.pub2
12. Acar HV. Acupuncture and related techniques during perioperativeperiod: a literature review. Complement Ther Med. 2016;29:48-55. doi:10.1016/j.ctim.2016.09.013
13. Formenti P, Piuri G, Bisatti R, Pinciroli R, Umbrello M. Role ofacupuncture in critically ill patients: a systematic review. J TraditComplement Med. 2023;13(1):62-71.
14. Jankovic B. Neuroimmunomodulation from phenomenology tomolecular evidence. In: Fabris N, Markovic B, Spector N, JankovicB, eds. Neuroimmunomodulation: The state of the art. The New YorkAcademy of Sciences: 1994:1-38.
15. Cabıoğlu MT, Ergene N. The effect mecanism of acupuncture andclinical applications. Genel Tıp Derg. 2003;13(1):35-40.
16. Chen Z, Hendner J, Hedner T. Substance P induced respiratoryexcitation is blunted by delta-receptor specific opioids in the ratmedulla oblongata. Acta Physiol Scand. 1996;157(2):165-173.
17. Guyton AC, Hall JE. Textbook of medical physiology. WB Saunders:2001.
18. Takeshige C, Nakamura A, Asamoto S, Arai T. Positive feedback actionof pituitary beta-endorphin on acupuncture analgesia afferent pathway.Brain Res Bull. 1992;29(1):37-44.
19. Jin HO, Zhou L, Lee KY, Chang TM, Chey WY. Inhibition of acidsecretion by electrical acupuncture is mediated via beta endorfin andsomatostatin. Am J Physiol. 1996;271(3):G524-G530.
20. Fu H. What is the material base of acupuncture? The nerves! MedHypothes. 2000;54(3):358-359.
21. Pan B, Castro-Lopes JM, Coimbra A. Activation of anterior lobecorticotrophs by electroacupuncture or noxious stimulations in theanaesthetized rat, as shown by colocalization of fos protein with ACTHand β-endorphin and increased hormone release. Brain Res Bull.1996;40(3):175-182.
22. Malizia E, Andreucci G, Paolucci D, Crescenzi F, Fabbri A, Fraioli F.Electroacupuncture and peripheral beta endorphin and ACTH levels.Lancet. 1979;314(8141):535-536.
23. Wang JQ, Mao L, Han JS. Comparison of the antinociceptive effectsinduced by electroacupuncture and transcutaneous electrical nervestimulation in the rat. Int J Neurosci. 1992;65(1-4):117-129.
24. Cevik B, Tascı S. Effect of acupressure applıcatıon on pain management.J Health Sci. 2017;26(3):257-261.
25. Tekin A, Çevik C. Akupunktur Uygulaması Kitabı. TR Ministry ofHealth General Directorate Of Health Services: 2021.
26. Karakus Z, Yangoz ST, Ozer Z. The effect of acupressure on themanagement of cancer-related pain and anxiety: a systematic review. JHacettepe Univ Fac Nurs. 2022;9(1):63-72.
27. Shao XM, Shen Z, Sun J, et al. Strong manual acupuncture stimulationof “Huantiao” (GB 30) reduces pain-induced anxiety and p-erk inthe anterior cingulate cortex in a rat model of neuropathic pain.Evidence-Based Complement Alternat Med. 2015;2015:235491. doi:10.1155/2015/235491
28. Chen MR,Wang P,Cheng G,Guo X,Wei GW,Cheng XH. The warmingacupuncture for treatment of sciatica in 30 cases. J Tradit ChinMed.2009;29(1):50-53. doi: 10.1016/s0254-6272(09)60031-5
29. Zheng X, Meng J-B, Fang Q. Electroacupuncture reduces the dose ofmidazolam monitored by the bispectral index in critically ill patientswith mechanical ventilation: an exploratory study. Acupunct Med.2012;30(2):78-84. doi: 10.1136/acupmed-2011-010095
30. Feeney C, Bruns E, LeCompte G, Forati A, Chen T, Matecki A.Acupuncture for pain and nausea in the intensive care unit: a feasibilitystudy in a public safety net hospital. J Alternative Compl Med.2017;23(12):996-1004. doi: 10.1089/acm.2016.0323
31. Frontera JA. Delirium and sedation in the ICU. Neurocrit Care.2011;14(3):463-474. doi: 10.1007/s12028-011-9520-0
32. Joo C, Lee S, Kang JW, Lee JD. Acupuncture for postoperative delirium(POD): a systematic review and meta-analysis protocol. Medicine.2021;100(3):e23822. doi: 10.1097/MD.0000000000023822
33. Levy I, Gavrieli S, Hefer T, et al. Acupuncture treatment of delirium inolder adults hospitalized in internal medicine departments: an open-label pragmatic randomized-controlled trial. J Geriatr Psychiatr Neurol.2021;35(3):333-343. doi: 10.1177/0891988721996804
34. SunJL,Sung MS,Huang MY,Cheng GC,Lin CC.Effectiveness ofacupressure for residents of long-term care facilities with insomnia: arandomized controlled trial. Int J Nurs Stud. 2010;47(7):798-805. doi:10.1016/j.ijnurstu.2009.12.003
35. Hmwe NTT, Subramaniam P, Tan LP. Effectiveness of acupressure inpromoting sleep quality. Holistic Nurs Pract. 2016;30(5):283-293.
36. Kim WI, Youn HM. The effects of self-acupressure of wan-gol (G12),shinmun (H7), samumgyo (SP6) on clinical nurses’ sleep patterndisturbance and fatigue. Korean J Acupunct. 2004;21(2):81-93.
37. Arab Z, Shariati AR, Asayesh H, Vakili MA, Bahrami-Taghanaki H,Azizi H. A sham-controlled trial of acupressure on the quality of sleepand life in haemodialysis patients. Acupunct Med. 2016;34(1):2-6. doi:10.1136/acupmed2014-010369
38. Abbasi Tadwwi S, Saberi M, Akbari H. Effect of acupressure at shenmenacupoint on the sleep quality of nurses in emergency departmentsand intensive care units. Complement Med J. 2021;10(4):380-395. doi:10.32598/cmja.10.4.1025.1
39. Huong HTX, Alex M, Wan CC, Anh VH, Phuc BT. Pilot randomizedsham-controlled trial of self-acupressure to manage the symptomcluster of insomnia, depression, and anxiety in cancer patientsundergoing chemotherapy. Sleep Breath. 2021;26(1):445-456. doi:10.1007/s11325-021-02370-8
40. Funk GC, Anders S, Breyer MK, et al. Incidence and outcome ofweaning from mechanical ventilation according to new categories. EurRespir J. 2010;35(1):88-94. doi: 10.1183/09031936.00056909
41. Jia X, Malhotra A, Saeed M, Mark RG, Talmor D. Risk factors forARDS in patients receiving mechanical ventilation for> 48 h. Chest.2008;133(4):853-861. doi: 10.1378/chest.07-1121
42. Quan A, Cai G, Liu K, Zhong J, Shang L. Therapeutic observation ofacupuncture for gastrointestinal dysfunction in severe pneumonia.Shanghai J Acupunct Moxibust. 2017;(12):287-290.
43. Chen CH, Hsieh CL. Effect of acupuncture on oxidative stress inducedby cerebral ischemia-reperfusion injury. Antioxidants. 2020;9(3):248.doi: 10.3390/antiox9030248
44. Hu XY,TrevelyanE,Chai QY,et al. Effectiveness and safety of usingacupoint Shui Gou (GV 26): a systematic review and meta-analysis ofrandomized controlled trials. Acupunct Relat Therap. 2015;3(1):1-10.doi: 10.1016/j.arthe.2014.12.001
45. Zhang XF,Zhu J,Geng WY,et al. Electroacupuncture at Feishu (BL13)and Zusanli (ST36) down-regulates the expression of orexins and theirreceptors in rats with chronic obstructive pulmonary disease. J IntegrMed. 2014;12(5):417-424. doi: 10.1016/S2095-4964(14)60040-6
46. Umemoto K, Hayashi T, Fukushige K, et al. Specific acupuncturestimulation of Shenshu (BL23) affects sympathetic nervous activity-associated plasma renin concentration changes. J Tradit Chinese Med.2022;42(2):250-255.
47. Wu Z, Zheng Y, Chen Y, et al. The role of acupoint application of herbalmedicine for asthma: meta-analysis of randomized double-blindplacebo-controlled trials. Evidence-Based Complement Alternat Med.2022;2022:5589433. doi: 10.1155/2022/5589433
48. Zhang WP. Effects of acupuncture on the pulmonary function andheart rate variability in different state of bronchial asthma. Zhen Ci YanJiu=Acupunct Res. 2007;32(1):42-48.
49. Jiang LH, Li PJ, Wang YQ, et al. Anti-inflammatory effects ofacupuncture in the treatment of chronic obstructive pulmonarydisease. J Integr Med. 2023;21(6):518-527. doi: 10.1016/j.joim.2023.11.005
50. Moore FA, McKinley BA, Moore EE. The next generation in shockresuscitation. Lancet. 2004;363(9425):1988-1996. doi: 10.1016/S0140-6736(04)16415-5
51. Li P, Pitsillides KF, Rendig SV, Pan HL, Longhurst JC. Reversal ofreflex-induced myocardial ischemia by median nerve stimulation: afeline model of electroacupuncture. Circulation. 1998;97(12):1186-1194.doi: 10.1161/01.cir.97.12.1186
52. Hsu C, Hua Y, Jong G, et al. Shock resuscitation with acupuncture: casereport. Emerg Med J. 2006;23(3):e18. doi: 10.1136/emj.2004.023218
53. Choi GS, Oha SD, Han JB, et al. Modulation of natural killer cell activityaffected by electroacupuncture through lateral hypothalamic area inrats. Neurosci Lett. 2002;329(1):1-4. doi: 10.1016/s0304-3940(02)00551-7
54. Sato T, Yu Y, Guo SY, Kasahara T, Hisamitsu T. Acupuncturestimulation enhances splenic natural killer cell cytotoxicity in rats. JpnJ Physiol. 1996;46(2):131-136. doi: 10.2170/jjphysiol.46.131
55. Rho SW, Choi GS, Ko EJ, et al. Molecular changes in remote tissuesinduced by electro-acupuncture stimulation at acupoint ST36. MolCell. 2008;25(2):178-183.
56. Kim SK, Lee Y, Cho H, et al. A parametric study on theimmunomodulatory effects of electroacupuncture in DNP-KLH immunized mice. Evid Based Complement Alternat Med.2011;2011:389063. doi: 10.1093/ecam/nep166
57. Chen L, Xu A, Yin N, et al. Enhancement of immune cytokines andsplenic CD4þ T cells by electroacupuncture at ST36 acupoint of SD rats.PLoS One. 2017;12(4):e0175568. doi: 10.1371/journal.pone.0175568
58. Yang G, Hu R, Deng A, Huang Y, Li J. Effects of electro-acupunctureat Zusanli, Guanyuan for sepsis patients and its mechanism throughimmune regulation. Chin J Integr Med. 2016;22(3):219-224. doi: 10.1007/s11655-016-2462-9
59. Zou D, Chen WH, Iwakiri K, Rigda R, Tippett M, Holloway RH.Inhibition of transient lower esophageal sphincter relaxations byelectrical acupoint stimulation. Am J Physiol Gastrointest Liver Physiol.2005;289(2):G197-G201. doi: 10.1152/ajpgi.00023.2005
60. Tabosa A, Yamamura Y, Forno ER, Mello LEAM. A comparativestudy of the effects of electroacupuncture and moxibustion in thegastrointestinal motility of the rat. Dig Dis Sci. 2004;49(4):602-610. doi:10.1023/b: ddas.0000026305.20852.41
61. Jin HO, Zhou L, Lee KY, Chang TM, Chey WY. Inhibition of acidsecretion by electrical acupuncture is mediated via beta-endorphinand somatostatin. Am J Physiol. 1996;271(3):G524-G530. doi: 10.1152/ajpgi.1996.271.3.G524
62. Pfab F, Winhard M, Nowak-Machen M, et al. Acupuncture incritically ill patients improves delayed gastric emptying: a randomizedcontrolled trial. Anesth Analg. 2011;112(1):150-155. doi: 10.1213/ANE.0b013e3181fdfac8
63. Kao ML, Chen YL, Lee SC, Huang SY, Lin PY. Electroacupunctureimproves gastric emptying in critically ill neurosurgical patients: a pilotstudy. Evid Based Complement Alternat Med. 2017;2017:1892161. doi:10.1155/2017/1892161
64. Ben-Arie E, Kao PY, Ho WC, Lee YC. Acupuncture effect on digestionin critically ill postoperative oral and hypopharyngeal cancer patients.Medicine. 2019;98(35):e16944. doi: 10.1097/MD.0000000000016944
65. Ben-Arie E, Wei TH, Chen HC, et al. Digestion-specific acupunctureeffect on feeding intolerance in critically ill post-operative oral andhypopharyngeal cancer patients: a single-blind randomized controltrial. Nutrients. 2021;13(6):2110. doi: 10.3390/nu13062110
66. Schefold JC, Bierbrauer J, Weber-Carstens S. Intensive care unit-acquired weakness (ICUAW) and muscle wasting in critically illpatients with severe sepsis and septic shock. J Cachexia SarcopeniaMuscle. 2010;1(2):147-157. doi: 10.1007/s13539-010-0010-6
67. Babb T, Levine B, Philley J. ICU-acquired weakness: an extension of theeffects of bed rest. Am J Respir Crit Care Med. 2012;185(2):230-231. doi:10.1164/ajrccm.185.2.230
68. Song J, Li H, Cao Y, et al. Electroacupuncture improves survival in ratswith lethal endotoxemia via the autonomic nervous system. Anesthesiol.2012;116(2):406-414. doi: 10.1097/ALN.0b013e3182426ebd
69. Su Z, Hu L, Cheng J, et al. Acupuncture plus low-frequencyelectrical stimulation (Acu-LFES) attenuates denervation-inducedmuscle atrophy. J Appl Physiol. 2016;120(4):426-436. doi: 10.1152/japplphysiol.00175.2015
70. Zhou X, Xing B, He G, Lyu X, Zeng Y. The effects of electricalacupuncture and essential amino acid supplementation on sarcopenicobesity in male older adults: a randomized control study. Obes Facts.2018;11(4):327-334. doi: 10.1159/000491797
Volume 1, Issue 2, 2024
Page : 35-41