Comparison of Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) and Conventional Facemask Ventilation During Electroconvulsive Therapy in Major Mental Disorders: A Preliminary Open-Label Randomized Controlled Trial.
Can-Jin Deng, Sha Nie, Rong Zeng, Jian-Xin Mai, Xiong Huang, Shi-Chao Xu, Xin-Hu Yang, Qing-Bin Zeng, Xing-Bing Huang, Wei Zheng
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Abstract
Background: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) technique prolongs apnea duration. However, there is limited knowledge regarding the effectiveness and safety of THRIVE technique compared to conventional facemask ventilation during electroconvulsive therapy (ECT) in Chinese patients with major mental disorders.
Methods: Seventy adult individuals with major mental disorders (schizophrenia, n = 17; bipolar disorder, n = 25; major depressive disorder, n = 28) undergoing their first ECT session were assigned to either the THRIVE group (n = 35) or the facemask group (n = 35) based on the random sequence. The primary outcome was the lowest peripheral oxygen saturation (SpO2) levels. Secondary outcomes included the incidence of oxygen desaturation, electroencephalogram seizure duration, stimulation dosage, mean arterial pressure (MAP), average SpO2 levels, and heart rate (HR). Airway-related complications were documented within 24 hours following ECT.
Results: In the THRIVE group, the lowest SpO2 levels were notably higher than those in the facemask group (p < 0.05). Patients receiving THRIVE technique had consistently higher average SpO2 levels than those receiving conventional facemask ventilation (p < 0.05). The incidence of oxygen desaturation in THRIVE group was lower than that in facemask group (p > 0.05). Moreover, significant differences between two study groups were not observed in terms of electroencephalogram seizure duration, stimulation dosage, MAP, and HR (all ps > 0.05). No airway-related complications were reported in either group.
Conclusions: In this preliminary open-label randomized controlled trial, the THRIVE technique appeared to be more effective than conventional facemask ventilation in preserving SpO2 levels during ECT in major mental disorders, establishing itself as a safe and effective oxygenation alternative.
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