Jonker Yori, Rutten Dennis J, van Exel Eric R, Stek Max L, de Bruin Paul E, Huitink Johannes M
Medical Faculty, VU University.
Department of Psychiatry GGZ inGeest/VU University Medical Center, Amsterdam, the Netherlands.
J ECT. 2019 Jun;35(2):110-114. doi: 10.1097/YCT.0000000000000556.
In electroconvulsive therapy (ECT), a generalized seizure is provoked under general anesthesia. Standard airway management is done by face mask ventilation, but this is difficult during generalized seizure. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a method to increase apnea tolerance and permit apnea oxygenation. We hypothesize that THRIVE can oxygenate the patient during ECT and that it is comfortable for patients.
In this single-center feasibility study, 13 patients with a pharmacotherapy-resistant depressive disorder underwent 20 ECT sessions with the use of THRIVE. They received general anesthesia under standard monitoring and transcutaneous carbon dioxide monitoring. Afterward, they completed a survey comparing their prior experience with face mask oxygenation.
There were no desaturations during the procedure, and patient comfort showed no difference in comparison to face mask. Compared with data from earlier ECT with face mask ventilation in the same patient, THRIVE did not seem to shorten seizure duration.
THRIVE is a novel, safe oxygenation method during ECT.
在电休克治疗（ECT）中，需在全身麻醉下诱发全身性癫痫发作。标准气道管理通过面罩通气进行，但在全身性癫痫发作期间这很困难。经鼻湿化快速充气通气交换（THRIVE）是一种提高呼吸暂停耐受性并允许进行呼吸暂停氧合的方法。我们假设THRIVE可在ECT期间为患者提供氧合，并且对患者来说是舒适的。
在这项单中心可行性研究中，13例药物治疗抵抗性抑郁症患者使用THRIVE进行了2次ECT治疗。他们在标准监测和经皮二氧化碳监测下接受全身麻醉。之后，他们完成了一项调查，比较了他们之前使用面罩给氧的体验。
术中未出现氧饱和度下降，与面罩相比，患者舒适度无差异。与同一患者早期使用面罩通气的ECT数据相比，THRIVE似乎并未缩短癫痫发作持续时间。
THRIVE是ECT期间一种新型的、安全的氧合方法。
