Case series: acupuncture-related pneumothorax
Tóm tắt
Acupuncture has become a more popular complementary and alternative medicine worldwide. As pneumothorax is a rare acupuncture-related adverse event (AE), it is thought to be under-recognized by acupuncturists and emergency physicians, and the public is often not aware of this potential AE resulting in delayed hospital presentation. This is a case series of acupuncture-related pneumothoraces diagnosed in an emergency department (ED) in Singapore. Data was collected retrospectively from patients’ notes and prospectively from the patients over the phone. Between 2017 and 2021, 4 out of 474 (0.84%) pneumothoraces were acupuncture related. Three of these patients consented to participate in this study. One patient developed bilateral pneumothoraces. All 3 patients claimed that they were not informed by the acupuncturists of potential serious AEs prior to acupuncture treatments and that they were not aware that such AE could occur. All 3 patients had reported their symptoms of chest pain and/or breathlessness to their acupuncturists post-treatment, but they were not advised to seek urgent medical attention. When the 3 patients had informed their acupuncturists about their diagnosis of pneumothorax, 2 of the acupuncturists did not seem to be aware of this acupuncture-related AE. When pneumothorax manifests, there is a potential need for an invasive procedure and continuous monitoring as it may devolve into a life-threatening condition with cardiovascular compromise. Early medical recognition and attention are needed to ensure optimal patient outcomes. In the appropriate population cohort, a history of prior acupuncture treatments should be included as part of history-taking assessment in patients presenting with chest pain and/or breathlessness. Emergency physicians should be vigilant of this potentially serious and life-threatening complication for anyone presenting with chest discomfort and/or breathlessness after recently undergoing acupuncture to ensure earlier diagnosis, management, and better patient outcome.
Tài liệu tham khảo
Zhao L, Zhang FW, Li Y, Wu X, Zheng H, Cheng LH, et al. Adverse events associated with acupuncture: three multicentre randomized controlled trials of 1968 cases in China. Trials. 2011;12(1):1–9.
Witt CM, Pach D, Brinkhaus B, Wruck K, Tag B, Mank S, et al. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form. Complementary Medicine Research. 2009;16(2):91–7.
He W, Zhao X, Li Y, Xi Q, Guo Y. Adverse events following acupuncture: a systematic review of the Chinese literature for the years 1956–2010. The Journal of Alternative and Complementary Medicine. 2012;18(10):892–901.
Ernst E, White AR. Prospective studies of the safety of acupuncture: a systematic review. The American journal of medicine. 2001;110(6):481–5.
Öncel M, Tezcan B, Sunam GS. Iatrogenic bilateral pneumothorax after acupuncture. Respir Case Rep. 2013;2:158–9.
Advanced trauma life support: student course manual. 10th ed. Chicago: American College of Surgeons; 2018.
Walker SP, Barratt SL, Thompson J, Maskell NA. Conservative management in traumatic pneumothoraces: an observational study. Chest. 2018;153(4):946–53.
Figueroa JF, Karam BS, Gomez J, Milia D, Morris RS, Dodgion C, Carver T, Murphy P, Elegbede A, Schroeder M, de Moya MA. The 35-mm rule to guide pneumothorax management: Increases appropriate observation and decreases unnecessary chest tubes. J Trauma Acute Care Surg. 2022;92(6):951–7.
Traditional Chinese Medicine Practitioners Board. [Updated 2022 March 31; cited 2022 May 1]. Available from: https://www.healthprofessionals.gov.sg/tcmpb/en