Objective

2

To evaluate the effects of acupuncture or electro-acupuncture on feeding tolerance and nutritional status of patients with enteral nutrition in the intensive care unit （ICU）.

Methods

2

Electronic databases including Wanfang，CNKI，VIP，SinoMed，PubMed，Cochrane Library，Web of Science and Embase were searched for randomized controlled trials （RCTs） exploring the effect of acupuncture or electro-acupuncture on feeding tolerance and nutritional status in ICU patients from the inception dates to August 1st，2020. The papers meeting the inclusion and exclusion criteria were extracted for data and evaluated for quality assessment. RevMan 5.4 software was used to conduct meta-analyses on incidence of feeding intolerance and nutritional status. GRADE was used to assess the evidence quality of outcome.

Results

2

Fifteen RCTs were included involving 1271 patients. The meta-analyses results showed that compared to control group with routine treatment，acupuncture can significantly decrease the incidence of abdominal distension，diarrhea and vomiting，and increase the levels of prealbumin and hemoglobin （

P

＜0.05），but there were no statistically significant differences between groups in constipation incidence and feeding amount （

P

＞0.05）. Electro-acupuncture can decrease the incidence of abdominal distension，diarrhea，vomiting and regurgitation，increase the proportion of patients with nutrition status up to the standard，elevate the feeding amount and the levels of prealbumin and albumin，and reduce the proportion of parenteral nutrition and residual gastric volume （

P

＜0.05），but no statistically significant differences in constipation incidence，aspiration，and hemoglobin level were found between electro-acupuncture and routine treatment （

P

＞0.05）. According to the GRADE standard，the evidence on incidence of abdominal distention，diarrhea and vomiting compared between acupuncture and routine treatment was assessed as moderate certainty，while other outcomes were rated as low certainty. When compared between electro-acupuncture and routine treatment，the evidence on constipation incidence，aspiration rate，feeding amount，prealbumin level and albumin level were at low certainty； the evidence on residual gastric volume and hemoglobin level were at very low certainty，while that on other outcomes were at moderate certainty.

Conclusion

2

Compared to routine treatment and enteral nutrition，adjuvant acupuncture or electro-acupuncture has certain advantages in reducing feeding complications and improving nutritional status for ICU patients，but the advantages are not significant in reducing the incidence of constipation and increasing the feeding amount for acupuncture，and in reducing the constipation incidence and aspiration rate，and increasing the level of hemoglobin for electro-acupuncture.