title: Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy.
abstract: 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.
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94143, USA. cchoukal@gmail.com
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Choukalas
authors.forename: James
authors.initials: J
authors.lastname: Walter
authors.forename: David
authors.initials: D
authors.lastname: Glick
authors.forename: Michael F
authors.initials: MF
authors.lastname: O'Connor
authors.forename: Avery
authors.initials: A
authors.lastname: Tung
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Dinwiddie
authors.forename: Mark E
authors.initials: ME
authors.lastname: Nunnally
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide