AUTHOR=Ben-Arie Eyal , Lottering Bernice Jeanne , Chen Fang-Pey , Ho Wen-Chao , Lee Yu-Chen , Inprasit Chanya , Kao Pei-Yu 

TITLE=Is acupuncture safe in the ICU? A systematic review and meta-analysis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1190635

DOI=10.3389/fmed.2023.1190635

ISSN=2296-858X

ABSTRACT=Background and Purpose
The safety of interventions in critically ill patients is a crucial issue. In recent years, several studies have treated critically ill patients with acupuncture. However, the safety of acupuncture in this setting remains to be systematically measured. 
Methods
The electronic databases of PubMed and the Cochrane Library were searched in May 2022 for studies comparing acupuncture interventions to control interventions in critically ill patients.  Study outcomes examined the incidence of severe adverse events (AEs), minor AEs, adverse reactions, ICU stay, and 28-day mortality. 
Results 
A total of 31 articles were analyzed, and no serious AEs related to acupuncture treatment were identified. No significant differences were found between the groups in the meta-analysis of minor AEs (RR 5.69 [0.34, 96.60], P = 0.23 I2 = 76%). A reduced risk in the incidence of adverse reactions following acupuncture intervention was evidenced (RR 0.33 [0.22, 0.50], P = 0.00001, I2 = 44%). The patients of the acupuncture arm spent significantly less time in the intensive care unit (ICU) (RD -1.45 [-1.94, -0.97], P = 0.00001, I2 = 56%) and also exhibited lower 28-day mortality rates (OR 0.61 [0.48, 0.78], P = 0.0001, I2 = 0%).
Conclusion
There is no evidence to indicate a higher risk for severe or minor AEs in patients that receive acupuncture. Acupuncture demonstrated favorable results in both ICU stay and 28-day mortality measurements, in addition to presenting with fewer adverse reactions compared to routine ICU care. However, the low certainty of the evidence resultant from a high risk of bias in the included studies merits substantial consideration and further research is still warranted.