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Ventilation Adjustment in ECT During COVID-19: Voluntary Hyperventilation is an Effective Strategy
Aida de Arriba-Arnau1,2, Antònia Dalmau Llitjos3, Virginia Soria1,2,4
1Department of Psychiatry, Bellvitge University Hospital-ICS, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. L'Hospitalet de Llobregat, Barcelona, Spain.
Neuropsychiatric Disease and Treatment
|May 28, 2021
Summary
This study shows a modified ventilation technique for electroconvulsive therapy (ECT) effectively reduced infection risk during COVID-19 without adverse effects. The protocol optimized respiratory gas values and seizure duration.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Neurology
Background:
- Airway management is crucial in electroconvulsive therapy (ECT) to prevent COVID-19 transmission.
- Modified ventilation strategies are needed to minimize aerosol generation during ECT procedures.
Purpose of the Study:
- To evaluate a modified ventilation protocol for ECT aimed at reducing aerosol-generating bag-mask ventilation (BMV).
- To assess the effectiveness of the protocol in maintaining adequate respiratory gas exchange during ECT sessions.
Main Methods:
- Prospective study of a modified ventilation protocol involving preoxygenation and extended voluntary hyperventilation (VHV) with a face mask and nasal cannula.
- Assisted BMV with a sealed device was used, avoiding vigorous ventilation.
- Oxygen saturation (SpO2) and transcutaneous partial pressure of carbon dioxide (TcPCO2) were monitored.
Main Results:
- The protocol was applied in 74 ECT sessions across 15 subjects.
- Mean SpO2 increased by 2.12±2.14%, and mean TcPCO2 decreased by 4.05±2.98 mmHg post-VHV.
- Brief desaturation occurred in 4 sessions; no significant side effects were noted.
Conclusions:
- The modified ventilation protocol is effective and safe for ECT during the COVID-19 pandemic.
- The protocol successfully reduced BMV, induced moderate hypocapnia, and potentially optimized seizure parameters.
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