Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy

Abstract

Study objective: To compare the Mapleson D circuit and the bag-valve-mask device for mask ventilation of patients undergoing electroconvulsive therapy (ECT).

Design: Cross-over study.

Setting: Single-center academic medical center.

Patients: 18 patients undergoing ECT for major depressive disorder.

Interventions: Patients were randomized to undergo mask ventilation by the Mapleson D circuit or the bag-valve-mask device.

Measurements: End-tidal CO(2), seizure duration, and airway pressure values were recorded.

Main results: End-tidal CO(2) was significantly lower with the bag-valve-mask device. When compared with the bag-valve-mask device, ventilation with the Mapleson circuit resulted in rebreathing of CO(2) in nearly all patients, shorter expiratory time, and lower pressure ramp slope.

Conclusions: Hypocapnia was not associated with longer seizures, and the user-device interaction might affect device performance.