Acupoint Catgut Embedding Reduces Insulin Resistance in Diabetic Patients Undergoing Open Cardiac Surgery
Acupoint Catgut Embedding and Open Cardiac Surgery
Keywords:Acupoint catgut embedding, postoperative nausea and vomiting, length of hospital stay, open cardiac surgery
Objective: Acupoint catgut embedding (ACE) has been used safely for thousands of years in traditional Chinese medicine. The aim of this study was to assess whether ACE can improve insulin resistance and promote rapid recovery after open cardiac surgery.
Methods: A group of 200 patients undergoing cardiac surgery were randomly allocated to receive either ACE (ACE group) or sham ACE (SHAM group).
The primary outcome of our trial was insulin resistance assessed 1, 3, 5, and 7 days after surgery. The homeostasis model assessment (HOMA-IR) was used to measure perioperative insulin resistance. Secondary outcomes included insulin, glucose, and inflammatory cytokine (interleukin (IL) 6 and IL-8) levels; time to extubation; incidence of infection; time to first feces; acute kidney injury; incidence of postoperative nausea and vomiting (PONV); length of stay in the ICU; length of hospital stay; and other clinical parameters.
Results: The ACE group had lower insulin, glucose, IL-6, IL-8, and HOMA-IR levels than the SHAM group one week after the operation. The incidence of infection, incidence of PONV, time to drain removal, and length of hospital stay significantly were lower in the ACE group than in the SHAM group.
Conclusion: ACE can improve insulin resistance and promote rapid recovery after open cardiac surgery.
Anand KJ, Hansen DD, Hickey PR. 1990. Hormonal-metabolic stress responses in neonates undergoing cardiac surgery. Anesthesiology 73:661-670.
Antonio-Villa NE, Bello-Chavolla OY, Vargas-Vázquez A, et al. 2020. Metabolic Syndrome Study Group. The combination of insulin resistance and visceral adipose tissue estimation improves the performance of metabolic syndrome as a predictor of type 2 diabetes. Diabet Med Feb 15.
Barth E, Albuszies G, Baumgart K, et al. 2007. Glucose metabolism and catecholamines. Critical care medicine 35:508-518.
Bisgaard T, Kristiansen VB, Hjortsø NC, et al. 2004. Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy. Br J Surg 91:151–158.
Chen IJ, Yeh YH, Hsu CH. 2018. Therapeutic Effect of Acupoint Catgut Embedding in Abdominally Obese Women:A Randomized, Double-Blind, Placebo-Controlled Study. J Womens Health (Larchmt) 27:782-790.
Deng L, Lun Z, Ma X, Zhou J. 2014. “Clinical observation on regulating the three energizer by acupoint catgut embedding combined with abdominal acupuncture in treating abdominal obesity: a randomized controlled trial,” World Journal of Acupuncture – Moxibustion 24: 29–34.
Duggan EW, Carlson K, Umpierrez GE. 2017. Perioperative Hyperglycemia Management: An Update. Anesthesiology 126: 547-60.
Floh AA, McCrindle BW, Manlhiot C, et al. 2020. Feeding May Modulate the Relationship Between Systemic Inflammation, Insulin Resistance and Poor Outcome Following Cardiopulmonary Bypass for Pediatric Cardiac Surgery. J Parenter Enteral Nutr 44:308-317.
Gandhi GY, Nuttall GA, Abel MD, et al. 2005. Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Procd 80:862–866.
Garcia-Vivas JM, Carlos GH, Flavia BC, et al. 2014. Acupoint catgut embedding therapy with moxibustion reduces the risk of diabetes in obese women. Journal of Research in Medical Sciences the Official Journal of Isfahan University of Medical Sciences 19:610–616.
Hermanides J, Qeva E, Preckel B, Bilotta F. 2018. Perioperative hyperglycemia and neurocognitive outcome after surgery: a systematic review. Minerva anestesiologica 84:1178-88.
Investigators N-SS, Finfer S, Chittock DR, et al. 2009. Intensive versus conventional glucose control in critically ill patients.The New England journal of medicine 360:1283-97.
Karimian N, Kaneva P, Donatelli F, et al. 2019. Simple Versus Complex Preoperative Carbohydrate Drink to Preserve Perioperative InsulinSensitivity in Laparoscopic Colectomy: A Randomized Controlled Trial. Ann Surg Jul 26.
Kovac AL. 2013. Update on the management of postoperative nausea and vomiting. Drugs 73:1525–1547.
Liao JQ, Song X, Chen Y, et al. 2014. Clinical randomized controlled trials of acupoint catgut-embedding for simple obesity: a meta-analysis. Chinese acupuncture & moxibustion 34: 621–626.
Nygre J, Thorell A, Ljungqvist O. 2001. Preoperative oral carbohydrate nutrition: an update. Curr Opin Clin Nutr Metab Care 4:255–259.
Ouattara A, Lecomte P, Le Manach Y, et al. 2005. Poor intraoperative blood glucose control is associated with a worsened hospital outcome after cardiac surgery in diabetic patients. Anesthesiology 103:687–694.
Saager L, Duncan AE, Yared JP, et al. 2015. Intraoperative tight glucose control using hyperinsulinemic normoglycemia increases delirium after cardiac surgery. Anesthesiology 122:1214-23.
Sato H, Carvalho G, Sato T, et al. 2010. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 95:4338–4344.
Svanfeldt M, Thorell A, Hausel J, et al. 2007. Randomized clinical trial of the effect of preoperative oral carbohydratetreatment on postoperative whole-body protein and glucose kinetics. Br J Surg 94:1342-1350.
Vlasselaers D, Mesotten D, Langouche L, et al. 2010. Tight glycemic control protects the myocardium and reduces inflammation in neonatal heart surgery. Ann Thorac Surg 90:22-29.
Yang J, Jiang Y, Chen Y, et al. 2019. Acupressure the PC6 point for alleviating postoperative nausea and vomiting: A systematic review protocol. Medicine (Baltimore) 98:e16857.
Zhang Y, Min J. 2019. Preoperative Carbohydrate Loading in Gynecological Patients Undergoing Combined Spinal and Epidural Anesthesia. J Invest Surg 15:1-9.
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