Effects of acupressure therapy on anxiety, agitation and physiologic parameters in patients weaning from mechanical ventilation

The aim of this study is to assess the effect of acupressure on anxiety, agitation, respiratory and physiologic parameters in patients during weaning of mechanically ventilation in the intensive care unit.

Samples will be chosen from the patients admitted to Bu-Ali Sina hospital affiliated with Qazvin University of Medical Sciences. In this randomized controlled clinical trial, 80 patients will be randomly assigned to the experiment and control groups. The patients will be blinded to the study.

This study will be done in intensive care unit of Bu-Ali Sina hospital of Medical Science University in Qazvin city.

Inclusion criteria : Four score ≥ 9;Richmond from +2 to -2; PaO2 ≥ 60 mmHg ، ABG: FiO2 ≤ 40%، PaO2 ≥ 60 mmHg, 25≥ RR); age over 18 ; Patient intubated for past 48 hours; Are on ventilation with SIMV ،PSV mode; Hemoglobin ≥ 8 mg/dl ; Without malformation or grazes in pressure points ; Haveing no psychiatric illness ; Haveing no neuromuscular illness ; Haveing no active heart disease ; Haveing no neurologic disorder that affect on respiratory ; taking no psychiatric agent ; taking no neuromuscular blocker agent; taking no sedative during past 4 hours; PTT≤60) . Exclusion criteria: Patient with no cooperation up to the end of study; Weaning of mechanical ventilation; Death of patient during the study; Daley of weaning process.

Deep pressure in the experiment group and touch in the control group will perform at 5- acupoints on both sides of the body. The intervention will be carried out 20 minutes before weaning of mechanical ventilation by an educated person. The 5- acupoints include Zhongfu (Lu1), Taiyuan (Lu9), Hegu (Li4), Neiguan (Pc6) and Zusanli (St36). This technique is performed on one side of the body and then the other side of the body based on the patient's condition. Anxiety, agitation and oxygen saturation and the effect of anxiety on physiologic parameters including blood pressure, heart rate, oxygen saturation and respiratory indexes before the intervention, immediately after the intervention, under T-piece, 20 min after T-piece will be measured.

Anxiety, agitation, blood gases are measured and also the effects of anxiety on physiologic parameters including blood pressure, heart rate, Oxygen saturation of arterial blood and respiratory indexes before intervention, immediately after intervention, under T-Piece, 20 min after T-Piece.

Shahed University Vice chancellor for research

Eligible patients will be randomly assigned into two groups using permuted block randomization , Random numbers table will be used, Random allocation sequence will be determined using a computerized program.Opaque sealed sequentially numbered envelopes from number 1 to 80 will be used for allocation concealment

patients will be unaware of the groups’assignments.staff nurses in the ICU and the statistical analyzer will be blind to patients’allocation of the groups.