Acupuncture to Improve Comfort of Children on a Ventilator in the Intensive Care Unit

• Sponsor: Seattle Children's Hospital (Other)
• Overall Status: Completed
• CT.gov ID: NCT01848158
• Collaborator: (none)
• Enrollment: 17
• Location: 1
• Arms: 2
• Duration (Months): 39
• Patients Per Site Per Month: 0.4

Study Details

Study Description

Brief Summary

The purpose of this study is to determine whether acupuncture is effective at improving comfort in children on a ventilator in the intensive care unit. Our hypothesis is that the patients receiving acupuncture will require less medications to keep them comfortable than those who receive sham or fake acupuncture.

Condition or Disease	Intervention/Treatment	Phase
Agitation	Device: acupuncture; Device: sham acupuncture	N/A

Detailed Description

Rationale: Use of narcotics and benzodiazepines is common in the pediatric intensive care unit (PICU) to alleviate pain and anxiety, especially for patients who are mechanically ventilated. Pain control and sedation decrease oxygen consumption, facilitate mechanical ventilation, ensure patient safety and help patients tolerate nursing care. However, these medications can also have negative consequences. Patients receiving greater amounts of pharmacologic sedation in the intensive care unit (ICU) have longer duration of mechanical ventilation and ICU length of stay. In fact, daily interruption of sedation shortens duration of mechanical ventilation and ICU length of stay. Sedatives have also been associated with development of delirium in ICU patients and linked to delusional and disturbing memories and post-traumatic stress disorder (PTSD) after recovery from critical illness. Benzodiazepines and opiates are associated with abnormal sleep architecture. Furthermore, patients experience tolerance, physical dependency and withdrawal from these agents. Lastly, there is evidence that sedatives, anesthetics and opiates are associated with neurotoxicity in animal studies leading to growing concern about the potential effects of these agents on the developing brains of children.

Novel Approach: In light of these negative aspects of pharmacologic sedation, we are looking for alternative ways to provide comfort to critically ill children in the PICU. Acupuncture has been found to be effective in reducing anxiety, acute pain, procedural pain, post-operative pain, chronic pain, headache, infant colic, and has been found to reduce anesthetic requirement during surgery.

Study Plan: We plan to randomize patients 6 months - 17 yrs old who are receiving mechanical ventilation in the PICU to either acupuncture or sham acupuncture as an adjunct to standard of care pharmacologic sedation as prescribed by the PICU medical team caring for the patients. Our hypothesis is that those patients receiving acupuncture will require less medications to keep them comfortable. Our study is powered (80%) to detect a 33% decrease in pharmacologic sedation/analgesia.

Study Design

• Study Type: Interventional
• Actual Enrollment: 17 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: Safety, Feasibility & Effectiveness of Acupuncture as an Adjunct to Pharmacologic Treatment for Sedation and Analgesia in Mechanically Ventilated PICU Patients - A Pilot Study
• Study Start Date: Mar 1, 2013
• Actual Primary Completion Date: Jun 1, 2016
• Actual Study Completion Date: Jun 1, 2016

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Acupuncture Acupuncture treatment three times per week for up to two weeks.	Device: acupuncture; Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.; Other Names: Pyonex Singles, Seirin® (0.20 mm diameter, 1.5 mm long)
Sham Comparator: Sham Acupuncture Sham acupuncture three times per week for up to two weeks	Device: sham acupuncture; Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.; Other Names: Pyonex Singles, Seirin® (bandage only, no needle)

Outcome Measures

Primary Outcome Measures

1. Average Daily Dexmedetomidine mcg/kg/Day [from time of first acupuncture/sham treatment till time of extubation]

   Measured total amount of dexmedetomidine received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).

2. Average Daily Morphine Equivalents (mg/kg/Day) [from time of first acupuncture/sham treatment till time of extubation]

   Measured total amount of morphine equivalent received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).

3. Average Daily Midazolam Equivalents (mg/kg/Day) [from time of first acupuncture/sham treatment till time of extubation]

   Measured total amount of midazolam equivalent received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).

4. Average Daily Sedation Score [from time of first acupuncture/sham treatment till time of extubation]

   To capture a global view of sedation and account for the combination of medications received, we also calculated an average daily 'sedation score' normalized for weight from the time of first treatment through extubation. The sedation score is a summary measure of sedative and analgesic exposure for mechanically ventilated children in the ICU. This score incorporates opioids, benzodiazepines, barbiturates, chloral hydrate, propofol, and antihistamines. Morphine and midazolam equivalents of 0.1 mg/kg, pentobarbital 2 mg/kg, chloral hydrate 50 mg/kg, any propofol use, and any phenobarbitol use are each allocated one point, while any antihistamine use receives a score of 0.5 (Randolph 2002, Curley 2005). We modified this score to include dexmedetomidine, assigning 1 point for 1 μg/kg of dexmedetomidine. The minimum value possible is zero, and there is no pre-defined maximum value. A higher score indicates higher dose of sedation medications (normalized by weight).

Secondary Outcome Measures

1. Number of Participants With Skin Ulceration at Acupuncture/Sham Sites [From time of first treatment through 2 to 3 days after last treatment.]

2. Number of Participants With Hematoma at Acupuncture/Sham Sites [From time of first treatment through 2 to 3 days after last treatment.]

3. Number of Participants With Cellulitis at Acupuncture/Sham Sites [From time of first treatment through 2 to 3 days after last treatment.]

4. Number of Participants Who Are Diagnosed With Bacteremia During the Study [From time of first treatment through 2 to 3 days after last treatment.]

5. Number of Participants Who Are Diagnosed With Septic Shock During the Study [From time of first treatment through 2 to 3 days after last treatment.]

6. Death While Enrolled in Study [From time of first treatment through 2 to 3 days after last treatment.]

Eligibility Criteria

Criteria

• Ages Eligible for Study: 6 Months to 17 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• age ≥6 months to <18 years

• intubated and mechanically ventilated

• patient requires pharmacologic sedation/analgesia to tolerate mechanical ventilation

• ≤72 hours of mechanical ventilation at time of enrollment with anticipated need of mechanical ventilation for at least ≥48 hours more (in order to be able to receive at least one acupuncture session)

• approval of treating physician

Exclusion Criteria:

• underlying neurologic condition that could impact sedation/analgesia needs

• coagulopathy (inr ≥ 1.8) or history of spontaneous bruising

• thrombocytopenia (platelets <20,000 that has not been treated with a platelet transfusion)

• hemodynamic instability (on continuous infusion of vasopressor or inotrope)

• sepsis or bacteremia on antibiotic therapy <24 hours

• severe generalized skin disorder (e.g., epidermolysis bullosa, Stevens-Johnson)

• ward of state

• being treated with therapeutic level of systemic anticoagulation (e.g., heparin with unfractionated heparin activity level ≥0.3, enoxaparin with low molecular weight heparin activity level ≥0.5, warfarin with inr ≥1.8)

• immunosuppressed (on chemotherapy {e.g., daunorubicin, vincristine}, immunosuppressive medications {e.g., sirolimus, tacrolimus, cyclosporine, mycophenolate mofetil, high dose steroids >4mg/kg/day}, or immunosuppressive biologics {e.g., thymoglobulin, etanercept, infliximab, adalimumab, rituximab})

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Seattle Children's Hospital	Seattle	Washington	United States	98105

Sponsors and Collaborators

• Seattle Children's Hospital

Investigators

• Principal Investigator: Jane L Di Gennaro, MD, MS, Seattle Children's Hopsital
• Principal Investigator: Anne Lynn, MD, Seattle Children's Hospital

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Lin Di Gennaro, Jane L. Di Gennaro, MD, Assistant Professor, Seattle Children's Hospital
• ClinicalTrials.gov Identifier: NCT01848158
• Other Study ID Numbers: 24849 Academic Enrichment Fund
• First Posted: May 7, 2013
• Last Update Posted: Aug 13, 2020
• Last Verified: Aug 1, 2020

• Keywords provided by Lin Di Gennaro, Jane L. Di Gennaro, MD, Assistant Professor, Seattle Children's Hospital: acupuncture; pediatric; critical care; mechanical ventilation; sedation; comfort
• Additional relevant MeSH terms: Psychomotor Agitation

Study Results

Participant Flow

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Period Title: Overall Study
STARTED	10	7
COMPLETED	10	7
NOT COMPLETED	0	0

Baseline Characteristics

Arm/Group Title	Acupuncture	Sham Acupuncture	Total
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.	Total of all reporting groups
Overall Participants	10	7	17
Age (years) [Median (Full Range) ]
Median (Full Range) [years]	2.4	1.0	1.7
Sex: Female, Male (Count of Participants)
Female	5 50%	5 71.4%	10 58.8%
Male	5 50%	2 28.6%	7 41.2%
Region of Enrollment (participants) [Number]
United States	10 100%	7 100%	17 100%
PRISM III (units on a scale) [Median (Full Range) ]
Median (Full Range) [units on a scale]	0	3	0

Outcome Measures

1. Primary Outcome

Title	Average Daily Dexmedetomidine mcg/kg/Day
Description	Measured total amount of dexmedetomidine received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).
Time Frame	from time of first acupuncture/sham treatment till time of extubation

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Mean (Standard Deviation) [mcg/kg/day]	11.08 (9.37)	17.42 (6.36)

2. Primary Outcome

Title	Average Daily Morphine Equivalents (mg/kg/Day)
Description	Measured total amount of morphine equivalent received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).
Time Frame	from time of first acupuncture/sham treatment till time of extubation

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Mean (Standard Deviation) [mg/kg/day]	1.04 (0.68)	1.61 (1.12)

3. Primary Outcome

Title	Average Daily Midazolam Equivalents (mg/kg/Day)
Description	Measured total amount of midazolam equivalent received from time of first acupuncture or sham treatment to extubation, normalized per weight and time on study (1st study treatment to extubation).
Time Frame	from time of first acupuncture/sham treatment till time of extubation

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Mean (Standard Deviation) [mg/kg/day]	0.73 (1.03)	0.97 (0.80)

4. Primary Outcome

Title	Average Daily Sedation Score
Description	To capture a global view of sedation and account for the combination of medications received, we also calculated an average daily 'sedation score' normalized for weight from the time of first treatment through extubation. The sedation score is a summary measure of sedative and analgesic exposure for mechanically ventilated children in the ICU. This score incorporates opioids, benzodiazepines, barbiturates, chloral hydrate, propofol, and antihistamines. Morphine and midazolam equivalents of 0.1 mg/kg, pentobarbital 2 mg/kg, chloral hydrate 50 mg/kg, any propofol use, and any phenobarbitol use are each allocated one point, while any antihistamine use receives a score of 0.5 (Randolph 2002, Curley 2005). We modified this score to include dexmedetomidine, assigning 1 point for 1 μg/kg of dexmedetomidine. The minimum value possible is zero, and there is no pre-defined maximum value. A higher score indicates higher dose of sedation medications (normalized by weight).
Time Frame	from time of first acupuncture/sham treatment till time of extubation

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Mean (Standard Deviation) [score on a scale]	29.0 (20.8)	43.4 (18.4)

5. Secondary Outcome

Title	Number of Participants With Skin Ulceration at Acupuncture/Sham Sites
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

6. Secondary Outcome

Title	Number of Participants With Hematoma at Acupuncture/Sham Sites
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

7. Secondary Outcome

Title	Number of Participants With Cellulitis at Acupuncture/Sham Sites
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

8. Secondary Outcome

Title	Number of Participants Who Are Diagnosed With Bacteremia During the Study
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

9. Secondary Outcome

Title	Number of Participants Who Are Diagnosed With Septic Shock During the Study
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

10. Secondary Outcome

Title	Death While Enrolled in Study
Time Frame	From time of first treatment through 2 to 3 days after last treatment.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Acupuncture	Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.	Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
Measure Participants	10	7
Count of Participants [Participants]	0 0%	0 0%

Adverse Events

Time Frame	From time of first treatment through 2 to 3 days after last treatment.
Adverse Event Reporting Description	Adverse events will be identified through review of the patient's hospital chart, discussion with treating medical team, and physical examination (to assess skin findings) every Monday, Wednesday and Friday while enrolled in the active phase of the trial (receiving acupuncture or placebo) and one additional evaluation 2 to 3 days after completing the last session of acupuncture or placebo (the Monday, Wednesday or Friday following the last study treatment).
Arm/Group Title	Acupuncture		Sham Acupuncture
Arm/Group Description	Acupuncture treatment three times per week for up to two weeks. acupuncture: Patients randomized to active treatment will receive acupuncture treatment with press needles (small acupuncture needles manufactured with attached bandage that makes the needle flush with skin) at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a seed magnet at ear shen men position for 4 hours on treatment days.		Sham acupuncture three times per week for up to two weeks sham acupuncture: Patients randomized to sham treatment will receive sham acupuncture with similarly appearing bandages placed without press needles attached at sites GV 24.5 or GV20, Ht 7 or Ht 3, Ki 3, Lr 3, LI 4 or LI 11, Lu 7 or Lu 5, Sp6, ST 36, using up to 15 points per patient three days per week for the duration of mechanical ventilation (maximum of 14 calendar days from the time of the first acupuncture treatment). We will also apply a similarly appearing bandage without seed magnet underneath at ear shen men position for 4 hours on treatment days.
All Cause Mortality
	Acupuncture		Sham Acupuncture
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/10 (0%)		0/7 (0%)
Serious Adverse Events
	Acupuncture		Sham Acupuncture
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/10 (0%)		0/7 (0%)
Other (Not Including Serious) Adverse Events
	Acupuncture		Sham Acupuncture
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/10 (0%)		0/7 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.