Key result
Noninvasive beat-to-beat blood pressure monitoring during electroconvulsive therapy is feasible and captured a transient drop in systolic BP to 91 ± 31 mm Hg followed by a rise to 192 ± 33 mm Hg.
Why the study?
Is noninvasive beat-to-beat arterial blood pressure measurement feasible for monitoring rapid hemodynamic effects in patients undergoing electroconvulsive therapy?
Observational (n=24)
Is noninvasive beat-to-beat arterial blood pressure measurement feasible for monitoring rapid hemodynamic effects in patients undergoing electroconvulsive therapy?
Noninvasive beat-to-beat blood pressure monitoring is feasible during ECT and captures rapid, significant hemodynamic fluctuations that could guide therapeutic interventions.
May enable real-time hemodynamic assessment during ECT; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVES: Rapid parasympathetic and sympathetic hemodynamic effects during electroconvulsive therapy (ECT) may pose vulnerable patients to significant risk for cardiovascular complications. Here, we evaluated the clinical feasibility of noninvasive beat-to-beat arterial blood pressure (BP) measurements in patients undergoing ECT. METHODS: Beat-to-beat hemodynamic effects were measured with a noninvasive BP monitor in 24 individual patients undergoing ECT during general anesthesia. Heart rate, systolic (SBP), and diastolic BP (DBP) as well as cardiac output (CO) were measured continuously. A significant increase in pulse rate and/or BP was treated with intermittent administration of esmolol and ketanserin. Data are presented as mean ± SD. RESULTS: The ECT stimulus induced a transient drop in BP and pulse rate, followed by a sharp rise in both parameters. The parasympathetic phase lasted 17 ± 9 seconds and was characterized by a drop in heart rate from 89 ± 15 to 42 ± 24 beats per minute, in SBP from 143 ± 22 to 91 ± 31 mm Hg, in DBP from 82 ± 13 to 54 ± 22 mm Hg, and in CO from 5.7 ± 2.3 to 1.4 ± 1.0 L/min, respectively. During the subsequent sympathetic phase, the heart rate increased to 125 ± 26 beats per minute, the SBP to 192 ± 33 mm Hg, the DBP to 113 ± 21 mm Hg, and the CO to 7.4 ± 4.3 L/min. The time interval between the lowest and highest SBP was 60 ± 48 seconds. CONCLUSIONS: Noninvasive beat-to-beat BP measurements are feasible during ECT and may be used to guide rapid therapeutic interventions during ECT-induced hemodynamic effects.
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Geersing et al. (2011) conducted an observational in Patients undergoing electroconvulsive therapy (n=24). Noninvasive beat-to-beat arterial blood pressure monitoring was evaluated on Beat-to-beat hemodynamic effects (heart rate, systolic and diastolic blood pressure, cardiac output). Noninvasive beat-to-beat blood pressure monitoring during electroconvulsive therapy is feasible and captured a transient drop in systolic BP to 91 ± 31 mm Hg followed by a rise to 192 ± 33 mm Hg.
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