COVID-Activated Emergency Scaling of Anesthesiology Responsibilities Intensive Care Unit.

In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic and the potential need for physicians to provide critical care services, the American Society of Anesthesiologists (ASA) has collaborated with the Society of Critical Care Anesthesiologists (SOCCA), the Society of Critical Care Medicine (SCCM), and the Anesthesia Patient Safety Foundation (APSF) to develop the COVID-Activated Emergency Scaling of Anesthesiology Responsibilities (CAESAR) Intensive Care Unit (ICU) workgroup. CAESAR-ICU is designed and written for the practicing general anesthesiologist and should serve as a primer to enable an anesthesiologist to provide limited bedside critical care services.

Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy.

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.