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Related Experiment Video

Updated: Mar 3, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
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Protocolized hyperventilation enhances electroconvulsive therapy.

Aida de Arriba-Arnau1, Antonia Dalmau2, Virginia Soria3

  • 1Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) Neurosciences Group-Psychiatry and Mental Health, L'Hospitalet de Llobregat, Barcelona, Spain.

Journal of Affective Disorders
|April 22, 2017
PubMed
Summary

Protocolized hyperventilation (PHV) in electroconvulsive therapy (ECT) effectively lowers carbon dioxide levels and increases seizure duration. This method optimizes ECT technique without additional costs, showing promising results for clinical practice.

Keywords:
Adverse effectsElectroconvulsive therapyHyperventilationHypocapniaSeizure durationSeizure quality

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Area of Science:

  • Anesthesiology
  • Neurology
  • Critical Care Medicine

Background:

  • Hyperventilation is a recommended adjunct in electroconvulsive therapy (ECT) to improve seizure efficacy and patient safety.
  • Optimal methods for hyperventilation during ECT require further investigation.

Purpose of the Study:

  • To compare protocolized hyperventilation (PHV) with usual hyperventilation (HVau) in ECT.
  • To assess the impact of PHV on transcutaneous partial pressure of carbon dioxide (TcPCO2) and seizure characteristics.

Main Methods:

  • A prospective study involving 21 subjects undergoing two consecutive ECT sessions.
  • Comparison of PHV and HVau, measuring TcPCO2, ventilation parameters, hemodynamics, seizure characteristics, and side effects.

Main Results:

  • PHV significantly reduced TcPCO2 compared to HVau throughout ECT sessions.
  • Seizure duration was significantly longer in sessions with PHV (p=.028).
  • No significant differences in other seizure parameters or adverse effects were observed.

Conclusions:

  • PHV effectively induces hypocapnia and prolongs seizure duration during ECT.
  • Voluntary hyperventilation is key to PHV's hypocapnic effect.
  • PHV is a cost-effective, easily applicable method to optimize ECT technique.