Mask ventilation, hypocapnia, and seizure duration in electroconvulsive therapy

Study ObjectiveTo compare the Mapleson D circuit and the bag-valve-mask device for mask ventilation of patients undergoing electroconvulsive therapy (ECT).DesignCross-over study.SettingSingle-center academic medical center.Patients18 patients undergoing ECT for major depressive disorder.InterventionsPatients were randomized to undergo mask ventilation by the Mapleson D circuit or the bag-valve-mask device.MeasurementsEnd-tidal CO2, seizure duration, and airway pressure values were recorded.Main ResultsEnd-tidal CO2 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 CO2 in nearly all patients, shorter expiratory time, and lower pressure ramp slope.ConclusionsHypocapnia was not associated with longer seizures, and the user-device interaction might affect device performance.