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.