The Safety of ECT in Patients With Chronic Obstructive Pulmonary Disease

BackgroundElectroconvulsive therapy (ECT) involves the administration of general anesthesia and assisted ventilation while the patient is apneic.ObjectiveCare must be taken to screen for significant pulmonary dysfunction before treatment. Very little has been written about the safety and management strategy of ECT patients with chronic obstructive pulmonary disease (COPD).MethodIn this retrospective chart review, authors describe their experience with patients in recent years who had this disorder and were treated with ECT.ResultsAuthors list recommendations for the pre-ECT work up and anesthetic management during and after the treatments.ConclusionRecent guidelines recommend administration of patients’ prescribed inhalers on the morning of ECT treatment. Also, caution is recommended when using ECT in patients taking theophylline because this drug has been associated with prolonged seizures and status epilepticus in these patients.