Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy.
OBJECTIVE
To compare the Mapleson D circuit and the bag-valve-mask device for mask ventilation of patients undergoing electroconvulsive therapy (ECT).


METHODS
Cross-over study.


METHODS
Single-center academic medical center.


METHODS
18 patients undergoing ECT for major depressive disorder.


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


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


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.
Choukalas
Christopher G
CG
Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94143, USA. cchoukal@gmail.com
Walter
James
J
Glick
David
D
O'Connor
Michael F
MF
Tung
Avery
A
Dinwiddie
Stephen H
SH
Nunnally
Mark E
ME
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D002245:Carbon Dioxide / Q000378:metabolism; D018592:Cross-Over Studies; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D006801:Humans; D016857:Hypocapnia / Q000150:complications* / Q000209:etiology; D008397:Masks; D008875:Middle Aged; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000379:methods; D012640:Seizures / Q000209:etiology; D012720:Severity of Illness Index; D013997:Time Factors
D002245:Carbon Dioxide