MINI REVIEW article
Front. Neurol.
Sec. Neurocritical and Neurohospitalist Care
This article is part of the Research TopicSleep, Circadian Rhythm, and Critical Illness. Evaluation and Management in the Intensive Care Unit and Post-ICU SettingsView all articles
Acupuncture for ICU Patients: Evidence, Mechanisms, and Implementation Challenges
Provisionally accepted
- 1Intensive Care Unit, Ningbo Municipal Hospital of Traditional Chinese Medicine (TCM), Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
- 2Department of Respiratory, Ningbo Municipal Hospital of Traditional Chinese Medicine (TCM), Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To explore the clinical applications, mechanisms of action, and methodological and implementation challenges of acupuncture in intensive care unit (ICU) patients, to provide a theoretical foundation for its standardization and evidence-based advancement. Methods: A comprehensive analysis of recent clinical studies, mechanistic investigations, and consensus guidelines regarding acupuncture use among ICU patients was conducted. The review summarizes its efficacy in analgesia and sedation, ICU-acquired weakness (ICU-AW), delirium, and gastrointestinal dysfunction, while systematically addressing aspects of infection control, procedural standardization, and research design. Results: Multiple randomized controlled trials (RCTs) and systematic reviews indicate that acupuncture interventions can effectively reduce reliance on analgesic and sedative medications, shorten the duration of mechanical ventilation and ICU stay, reduce the incidence of ICU-AW and delirium, and improve gastrointestinal motility. Mechanistic studies suggest that acupuncture exerts its effects via several pathways, including activation of the vagus nerve–cholinergic anti-inflammatory reflex, modulation of central analgesic networks, restoration of hypothalamic-pituitary-adrenal (HPA) axis homeostasis, and enhancement of microcirculation. However, clinical implementation remains limited by infection-control concerns, procedural heterogeneity, and the overall low quality of evidence. Conclusion: Current evidence indicates that acupuncture is generally safe and exerts multisystem regulatory effects in ICU patients, supporting its potential as a complementary therapy in critical care. Nevertheless, its role should be further validated through rigorous multicenter trials, standardized operational frameworks, and strict aseptic protocols prior to its incorporation into routine ICU practice.
Keywords: Acupuncture, analgesia and sedation, Aseptic technique, Delirium, Gastrointestinal dysfunction, ICU-acquired weakness, Intensive Care Unit, Standardization of Acupuncture
Received: 23 Sep 2025; Accepted: 10 Dec 2025.
Copyright: © 2025 LI, Wu, Wu, Ge, Zhang, Li and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fangyu Yu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.