1523 - Auricular and Scalp Acupuncture at End of Life: Improving Quality of Life in a Patient with Acute Respiratory Failure and Suspected Chronic Inflammatory Demyelinating Polyneuropathy

The patient is a 79-year-old male with CKD stage III, type 2 diabetes, hypertension, GERD, and suspected CIDP, admitted with lethargy and dyspnea. He had a recent hospitalization and received five sessions of IVIG with minimal improvement. On this admission, worsening weakness, dysphagia, and poor oral intake prompted neurology consultation and initiation of plasmapheresis (PLEX). EMG showed chronic axonal and demyelinating sensorimotor polyneuropathy. As his respiratory status declined, he developed acute on chronic respiratory failure. Acupuncture was requested by family to support comfort and function. Two treatments were performed using sterile Pyonex needles at Shen Men, lung auricular zones, PC6 bilaterally, Shishencong, and Yin Tang. The first session improved swallowing, allowing limited oral intake. The second reduced dyspnea and improved respiratory comfort. Despite these transient benefits, his condition worsened. After multidisciplinary discussion and shared decision-making, the family transitioned him to comfort-focused care.

Discussions:

This case illustrates the potential role of acupuncture in enhancing quality of life at the end of life, particularly in patients with neuromuscular disease. Targeted auricular and scalp acupuncture provided symptomatic relief and temporary functional gains in swallowing and breathing. While not curative, such integrative approaches may help align care with patient and family goals in serious illness.In patients with progressive neuromuscular decline and respiratory failure, acupuncture may serve as a low-risk adjunct to improve comfort and quality of life. This case supports further exploration of integrative modalities in palliative care settings.

Conclusions: In patients with progressive neuromuscular decline and respiratory failure, acupuncture may serve as a low-risk adjunct to improve comfort and quality of life. This case supports further exploration of integrative modalities in palliative care settings.