Rédacteur : Johan Nguyen
Sommaire
Cardiopulmonary Resuscitation
Réanimation cardiopulmonaire
1. Systematic Reviews and Meta-Analysis
1.1. Generic Acupuncture
1.1.1. Liu 2023
Liu Y, Ren M, Kuang Z, Luo X, Li H, Zhang Y, Wen W, Cai Y, Ni X, Chen Y. Efficacy of acupuncture for cardiopulmonary cerebral resuscitation: A systematic review and meta-analysis. Integr Med Res. 2023 Mar;12(1):100925. https://doi.org/10.1016/j.imr.2023.100925
| Background | Cerebral resuscitation is one of the main therapeutic aims in the treatment of cardiac arrest (CA) patients who experience a return of spontaneous circulation (ROSC). However, the therapeutic effects of current treatments are not ideal. The purpose of this study was to evaluate the efficacy of neurological function of acupuncture combined with conventional cardiopulmonary cerebral resuscitationthe (CPCR) for patients after ROSC. |
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| Methods | Seven electronic databases and other related websites were searched to identify studies on acupuncture combined with conventional CPCR for patients after ROSC. R software was used to conduct a meta-analysis, and the outcomes that could not be pooled were analyzed using a descriptive analysis. |
| Results | Seven RCTs involving 411 participants who had experienced ROSC were eligible for inclusion. The main acupoints were Neiguan (PC6), Shuigou (DU26), Baihui (DU20), Yongquan (KI1), and Sanyinjiao (SP6). Compared to conventional CPCR, acupuncture combined with conventional CPCR led to significantly higher Glasgow Coma Scale (GCS) scores on day 3 (mean difference (MD)=0.89, 95% CI: 0.43, 1.35, I2 = 0%), day 5 (MD = 1.21, 95% CI: 0.27, 2.15; I2 = 0%), and day 7 (MD = 1.92, 95% CI: 1.35, 2.50; I2 = 0%). |
| Conclusion | Acupuncture-assisted conventional CPCR may have a potential role in improving neurological function in CA patients after ROSC, but the certainty of evidence is very low and more high-quality studies are required. |
1.1.2. Wu 2020
Wu Yanhua. [Meta-analysis and Systematic Evaluation of Acupuncture in Cardiopulmonary Resuscitation]. Journal of Emergency in TCM. 2020. [212948].
| Objective | To systematically evaluate the effectiveness of acupoint acupuncture in improving the effect of cardiopulmonary resuscitation (CPR). |
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| Methods | RCTs of acupuncture in CPR were searched from science databases, such as CNKI, VIP, Wanfang data, CBM, PubMed, Embase, the Cochrane Library and Web. The quality of RCTs were evaluated by the Cochrane scale, and RevMan5. 3 software was used to meta-analyze ROSC rate, MAP, SpO2 level and survival rate after resuscitation. |
| Results | 259 patients were included in 4 RCTs. Meta-analysis results showed that acupuncture in CPR did not improve ROSC rate[OR=2. 31, 95%CI (0. 68, 7. 83), P > 0. 05]and the survival rate[OR=2. 27, 95%CI= (0. 92, 5. 61), P > 0. 05], but increased MAP[MD=7. 12, 95%CI= (2. 16, 12. 07)and SpO2 level[MD=9. 60, 95% CI= (3. 43, 15. 77), P = 0. 002]. |
| Conclusion | The curative effect of acupuncture in CPR has no obvious increase, but acupuncture may play a certain role in promoting the process of resuscitation. All the research methods and reports included in this system are low quality, and the sample size is small. Therefore, the clinical efficacy of acupuncture in CPR still needs to be verified by rigorous, large-sample randomized double-blind trials. |
