Cerebral Oxygenation and Systemic Hemodynamic Changes in Adolescents and Adults Undergoing Modified Electroconvulsive Therapy: A Prospective Observational Study.

Abstract

Objectives: The study aimed to evaluate the effect of modified electroconvulsive therapy (ECT) on cerebral oxygen saturation (rSO2), heart rate (HR), mean blood pressure (MBP), and peripheral oxygen saturation (SpO2) in adolescents both within and across multiple ECT sessions and compare those with adults.

Methods: We prospectively recruited adolescents (less than 18 y) and gender-matched adults (18 to 24 y) undergoing ECT and monitored rSO2, SpO2, HR, and MBP up to 15 minutes during each session, from the second to the sixth session (T2 to T6). Linear mixed-effect models were used to analyze.

Results: Twenty-five adolescents and 20 adults were included. Within an individual ECT session, adolescents exhibited a significant increase in rSO2 at the first and second minutes following ECT (P<0.001), and the increase was greater in adolescents than adults. Post-ECT, SpO2 and MBP showed an initial rise followed by a gradual decline in both groups, while HR remained elevated till the 15th minute in both groups. Relative to the T2 session, rSO2 values remained stable across the sessions and did not differ between groups. No clinically relevant changes were noted in SpO2 and MBP across the ECT sessions. Compared with the T2, the HR consistently increased in the T4 to T6 sessions in both groups (all P<0.001).

Conclusion: Both adolescents and adults demonstrated an acute increase (a significantly greater increase in adolescents), followed by a gradual decline in rSO2, SpO2, and MBP during a single ECT session, except for HR, which remained elevated. Across the ECT sessions, these variables remained stable in both groups.