AzTrials
AzTrials

Gastrointestinal DysfunctionNCT07692282

Study on Neostigmine Acupoint Injection at Zusanli(ST36) for Treating Mechanical Ventilation-Associated Gastrointestinal Dysfunction

A study testing Neostigmine Acupoint Injection, Neostigmine subcutaneous injection and Acupoint normal saline injection in people with Gastrointestinal Dysfunction, run by Southeast University, China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Mechanical ventilation is a common method of respiratory support for critically ill patients, and gastrointestinal dysfunction (GIDF) is a frequent complication. In the ICU, more than 60% of mechanically ventilated patients experience gastrointestinal dysfunction. Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Gastrointestinal Dysfunction
What is being tested?
Neostigmine Acupoint Injection, Neostigmine subcutaneous injection and Acupoint normal saline injection
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
No sites listed yet
Study dates
1 Jul 2026to Feb 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Respiratory failure due to any cause requiring mechanical ventilation, with an anticipated duration of mechanical ventilation of ≥48 hours;
  • No spontaneous bowel movements for ≥48 hours or increased gastric residual volume (gastric residual volume >500 mL within 24 hours);
  • Anticipated ICU stay of ≥3 days;
  • Age ≥18 years and ≤85 years.

Who cannot join

  • Use of prokinetic agents, subcutaneous or acupoint injections of neostigmine, or acupuncture at the Zusanli acupoint within 12 hours prior to enrollment;
  • History of gastrointestinal surgery within the past 8 weeks; diarrhea within the past week; or history of severe gastrointestinal diseases such as mechanical intestinal obstruction, intestinal ischemia and necrosis, inflammatory bowel disease, or active gastrointestinal bleeding;
  • Patients with an allergy to neostigmine or contraindications to its use, such as mechanical intestinal obstruction, urinary tract obstruction, bronchial asthma, bradycardia, hypotension, epilepsy, or Parkinson's disease;
  • Patients unable to undergo acupoint injection due to skin lesions, infection, limb loss, or inability to cooperate at the Zusanli acupoint;
  • Patients currently requiring routine treatment with neostigmine or similar cholinesterase inhibitors for other indications (e.g., myasthenia gravis, multiple sclerosis, Parkinson's disease);
  • Patients with a platelet count <50 × 10⁹/L on complete blood count or severe coagulation disorders (International Normalized Ratio [INR] >3);
Show all 11Show fewer
  • Severe hepatic impairment (Child-Pugh Class C) or hepatic encephalopathy;
  • End-stage renal failure requiring dialysis prior to admission;
  • Patients with hemodynamic instability (norepinephrine equivalent > 1.0 μg/kg·min);
  • Patients who have participated in other interventional clinical trials within the past month;
  • Pregnant, perinatal, or lactating women.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Airan Liu professor contact

8615295557466

airanliu@126.com

About this study

Official title: A Single-Center,Randomized Controlled Study on Neostigmine Acupoint Injection at Zusanli(ST36) for Treating Mechanical Ventilation-Associated Gastrointestinal Dysfunction

Mechanical ventilation is a common method of respiratory support for critically ill patients, and gastrointestinal dysfunction (GIDF) is a frequent complication. In the ICU, more than 60% of mechanically ventilated patients experience gastrointestinal dysfunction. Currently, the exact causes of mechanical ventilation-induced gastrointestinal dysfunction remain unclear, but they primarily include increased intra-abdominal pressure resulting from positive-pressure ventilation, which inhibits gastrointestinal motility; inflammatory responses, prolonged bed rest, electrolyte imbalances, and the use of sedatives, analgesics, and even muscle relaxants . Manifestations such as gastroparesis and constipation further lead to delayed gastric emptying, increased intra-abdominal pressure, and heightened risks of bacterial translocation, multiple organ failure, and ventilator-associated pneumonia. Primary Objective is to investigate, through a prospective randomized controlled trial, the efficacy of neostigmine injection at the Zusanli acupoint compared to Zusanli acupoint stimulation alone or subcutaneous neostigmine injection in improving gastrointestinal function in patients with mechanical ventilation and gastrointestinal dysfunction. Secondary objectives: (1)To evaluate the effects of acupoint injection of neostigmine on the duration of mechanical ventilation, enteral nutrition intake, and ICU length of stay in critically ill patients; (2)To assess the safety of acupoint injection of neostigmine.

Being tested
Neostigmine Acupoint Injection, Neostigmine subcutaneous injection, Acupoint normal saline injection
Keywords
Gastrointestinal Dysfunction, Zusanli(ST 36), neostigmine, Mechanical Ventilation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Neostigmine Acupoint InjectionDrug

    On the basis of standard treatment, neostigmine was injected into the bilateral Zusanli (ST36) acupoints. The patient was placed in the supine position with knees flexed. Following routine local disinfection, a 5 mL disposable syringe was used to extract 0.5 mg of neostigmine for vertical subcutaneous needling and injection. Upon needle withdrawal, the puncture site was compressed with sterile cotton swabs for hemostasis. The identical procedure was applied to the contralateral Zusanli acupoint. The intervention period is 1 day, with interventions administered twice daily (bid), 12 hours apart.

  • Neostigmine subcutaneous injectionDrug

    On the basis of standard treatment, subcutaneous injection was performed at non-acupoint sites. A 5 mL disposable syringe was used to aspirate 1 mg of neostigmine injection for single-site injection. The injection site received routine disinfection beforehand. Following the injection, the needle was withdrawn, and the puncture site was compressed with sterile cotton swabs for hemostasis.The intervention period is 1 day, with interventions administered twice daily (bid), 12 hours apart.

  • Acupoint normal saline injectionDrug

    On the basis of standard treatment, normal saline was injected into bilateral Zusanli (ST36) acupoints. The patient was placed in the supine position with knees flexed. After routine local disinfection, a 5 mL disposable syringe was used for vertical needle insertion, and an equal volume of normal saline was injected subcutaneously into each acupoint. Following injection, the needle was withdrawn, and the puncture site was compressed with sterile cotton swabs for hemostasis.The intervention period is 1 day, with interventions administered twice daily (bid), 12 hours apart.

Study groups in NCT07692282
Study groupRoleWhat they receive
neostigmine injection at the acupointsExperimentalNot described
Receives: Drug: Neostigmine Acupoint Injection
intramuscular injection of normal salineActive comparatorNot described
Receives: Drug: Acupoint normal saline injection
subcutaneous injection of neostigmineActive comparatorNot described
Receives: Drug: Neostigmine subcutaneous injection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Remission rate of gastrointestinal symptoms within 24 hours

    Gastrointestinal symptom relief is defined as meeting both recovery of spontaneous defecation (i.e., the first defecation after initial intervention with a defecation volume > 100 mL) and improvement in 24-hour gastric retention (24-hour gastric retention volume ≤ 500 mL).

    Measured: within 24 hours after treatment

Secondary outcomes (25)
  1. 28-day mortality

    Mortality was calculated on day 28 of treatment

    Measured: From randomization to Day 28

  2. ICU mortality

    the survival rate(survival/total) during ICU stay

    Measured: up to 24 months

  3. Length of ICU stay

    Time of staying in ICU within 28 days

    Measured: up to 28 days

  4. Infection condition

    Infection condition within 28 days

    Measured: From randomization to Day 28

  5. 28-day vasopressor-free days

    28-day vasopressor-free days is defined as a continuous period of 28 days, beginning from the time a patient is weaned from shock, circulatory failure, or mechanical circulatory support, during which no vasoactive drugs are used at any time, and the patient maintains stable circulation without the need for vasopressors agents to sustain blood pressure and tissue perfusion.

    Measured: From randomization to Day 28

  6. 28-day ventilator-free days

    Ventilator-free days are defined as the number of days alive and free from invasive mechanical ventilation during the first 28 days after randomization.

    Measured: From randomization to Day 28

  7. Length of hospital stay

    Length of hospital stay

    Measured: prior to hospital discharge

  8. Enteral Nutrition Prescription

    Enteral Nutrition Prescription was recorded before treatment,on day 1 of treatment,on day 3 of treatment,and on day 7 of treatment.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment,on day 7 of treatment

  9. Intra-abdominal pressure(mmHg)

    The patient was placed in the supine position. A urinary catheter was inserted transurethrally and connected to a three-way stopcock. Then 25 mL of 0.9% normal saline was injected. Taking the level of the pubic symphysis as the zero point, the water column height at the end of expiration was measured and recorded.IAP readings must be converted to mmHg.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  10. Bowel sounds

    Bowel sounds (times/min) were auscultated daily at a fixed time point before and after treatment over the right lower abdomen with a stethoscope. Each continuous auscultation lasted 3 minutes; the frequency of bowel sounds per minute was recorded, and the mean value of three repeated measurements was calculated.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  11. motilin

    Venous blood samples of 2 mL were collected in the early morning before treatment, on day 1 and day 3 after treatment. The levels of motilin (MTL) were determined and recorded.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  12. gastrin

    Venous blood samples of 2 mL were collected in the early morning before treatment, on day 1 and day 3 after treatment. The levels of gastrin (GAS) were determined and recorded.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  13. vasoactive intestinal peptide

    Venous blood samples of 2 mL were collected in the early morning before treatment, on day 1 and day 3 after treatment. The levels of vasoactive intestinal peptide (VIP) were determined and recorded.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  14. electrogastroenterography changes:FP(cpm)

    An electrogastroenterograph (Model EGEG-8D) was adopted. During examination, all subjects were placed in the supine position. Electrogastroenterography was performed before treatment, at 1 day and 3 days after treatment, and the main frequency (FP) (cpm) were recorded.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  15. hemoglobin

    Hemoglobin(g/L) are measured at baseline ,Day1, and Day3 as a marker of nutritional condition.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  16. albumin

    Serum albumin levels(g/L) are measured at baseline ,Day1, and Day3 as a marker of nutritional condition.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  17. prealbumin

    Serum prealbumin levels(mg/L) are measured at baseline ,Day1, and Day3 as a marker of nutritional condition.

    Measured: before treatment,on day 1 of treatment,on day 3 of treatment

  18. White blood cell count

    Serum White blood cell count (10^9/L) is measured at baseline ,Day1, and Day3 as a marker of a systemic inflammatory response.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  19. Lymphocyte count

    Serum lymphocyte count (10^9/L) is measured at baseline ,Day1, and Day3 as a marker of a systemic inflammatory response.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  20. C-reactive protein

    Serum C-reactive protein levels(mg/L) are measured at baseline ,Day1, and Day3 as a marker of a systemic inflammatory response.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  21. Procalcitonin

    Serum procalcitonin protein levels(ng/mL) are measured at baseline ,Day1, and Day3 as a marker of a systemic inflammatory response.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  22. electrogastroenterography changes:FC(cpm)

    An electrogastroenterograph (Model EGEG-8D) was adopted. During examination, all subjects were placed in the supine position. Electrogastroenterography was performed before treatment, at 1 day and 3 days after treatment, and the mean frequency (FC) were recorded.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  23. electrogastroenterography changes:AP(uV)

    An electrogastroenterograph (Model EGEG-8D) was adopted. During examination, all subjects were placed in the supine position. Electrogastroenterography was performed before treatment, at 1 day and 3 days after treatment, and amplitude was recorded.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

  24. Actual feeding amount

    Actual feeding amount (kcal)was recorded before treatment, on day 1 of treatment, on day 3 of treatment, on day 7 of treatment.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment, on day 7 of treatment.

  25. Intestinal diameter

    Using a Philips ultrasound machine, the intestinal diameter(cm) was assessed by scanning with a convex probe while the patient was in the supine position before treatment, 1 day after treatment, and 3 days after treatment.

    Measured: before treatment, on day 1 of treatment, on day 3 of treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Jul 2026
  2. Study start1 Jul 2026 (estimated)
  3. Primary completionFeb 2028 (estimated)
  4. Study completionFeb 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Care provider
Enrolment
90 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07692282
Sponsor's protocol ID
ST36 Acupoint injection
Other IDs
2026ZDSYLL103-P01
Status last verified
Jul 2026
First submitted
26 Jun 2026
Last updated
9 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Neostigmine Acupoint Injection, Neostigmine subcutaneous injection and Acupoint normal saline injection in people with Gastrointestinal Dysfunction, run by Southeast University, China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 9 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Airan Liu professor (8615295557466, airanliu@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Remission rate of gastrointestinal symptoms within 24 hours (time frame: within 24 hours after treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jul 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in