title: Recurrent Aspiration in a Patient With Gastric Band Undergoing Electroconvulsive Therapy.
abstract: We report a case of a 33-year-old woman with depression and suicidal ideation, treated successfully with electroconvulsive therapy (ECT) in the past. Since her previous course of ECT, she underwent gastric banding, a bariatric surgical procedure associated with increased risk of gastric regurgitation. Despite increasingly stringent measures to minimize the risk of regurgitation and aspiration during ECT, she had several episodes of regurgitation, the last of which precipitated an acute illness consistent with aspiration pneumonitis. We took additional precautions after each event, until she had no further episodes of regurgitation. We discuss the risk posed by the gastric band, the measures we implemented to minimize that risk, and our recommendations for assessment and management of post-gastric banding patients who present for ECT.
authors.affiliation: From the Departments of *Anesthesiology and †Psychiatry, New York University School of Medicine, NYU Langone Medical Center, New York, NY.
authors.forename: Elana B
authors.initials: EB
authors.lastname: Lubit
authors.forename: Tammy Cohen
authors.initials: TC
authors.lastname: Fetterman
authors.forename: Patrick
authors.initials: P
authors.lastname: Ying
mesh_terms: D000328:Adult; D000758:Anesthesia; D050110:Bariatric Surgery / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D002637:Chest Pain / Q000209:etiology; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012008:Recurrence; D063466:Respiratory Aspiration of Gastric Contents / Q000209:etiology* / Q000517:prevention & control