Cardioprotective effect of transcutaneous electric acupoint stimulation in the pediatric cardiac patients: a randomized controlled clinical trial

Summary Background:  Acupuncture pretreatment exerts neuroprotective and cardioprotective effects in animal models and in adult patients underwent cardiac surgery; however, data in pediatric patient are unavailable. Objective/Aim:  To investigate the effects of transcutaneous electric acupoint stimulation (TEAS) on acute myocardial injury from pediatric open-heart surgery. Methods:  Children, aged 2–12 years, with congenital heart defects scheduled for surgical repair were enrolled. They were randomized to TEAS (administrated at bilateral P6 acupoint for 30 min after basal anesthesia) and control (an electrode was placed on the arm without stimulus) groups. The primary end point was serum cardiac troponin I (cTnI) over 24 h after aortic unclamping. Furthermore, clinical outcome and serum cytokine and C-reactive protein concentrations were evaluated. Results:  Seventy eligible children were analyzed, 36 in controls and 34 in TEAS group. Compared with controls, the mean cTnI levels were significantly lower in TEAS group at 8 h (P = 0.043) and 24 h (P = 0.046) after aortic unclamping. The duration of ventilation (P = 0.004) and length of ICU stay (P = 0.032) was significantly longer in controls than in TEAS group. There was a significant difference in the release of C-reactive protein at 8 h (P = 0.039) between two groups, whereas the values for cytokines were not significant. Conclusion:  Transcutaneous electric acupoint stimulation on the bilateral P6 acupoint is effective for attenuation myocardial injury in children undergoing cardiac surgery. The beneficial effects may be partially associated with reduction in cTnI and C-reactive protein level in the early postoperative period.