Description of Hemodynamic Changes Over a Course of Electroconvulsive Therapy Series Using Continuous, Noninvasive Hemodynamic Monitoring: A Feasibility Trial.

OBJECTIVES

First aim was to demonstrate feasibility of continuous noninvasive blood pressure monitoring using the ClearSight System (Edwards Lifesciences Corp) in the setting of electroconvulsive therapy (ECT). Second aim was to evaluate the hemodynamic changes over multiple ECT sessions, allowing prediction and preemptive treatment of hemodynamic changes to reduce cardiovascular stress in subsequent sessions.

METHODS

In a subset of an ongoing RCT, patients' hemodynamic parameters were recorded using the ClearSight System™ from induction of anesthesia for up to 10 minutes.

RESULTS

One hundred forty-nine sessions in 14 patients were recorded. Hemodynamic monitoring using the ClearSight System was feasible in all patients with limitation of poor peripheral perfusion due to Raynaud syndrome in one patient and recording gaps in case of poor muscle relaxation. Hemodynamic patterns varied widely between individuals, but were comparable over multiple ECT sessions.

CONCLUSIONS

Individual hemodynamic reactions can be precisely assessed using the ClearSight System with only minor limitations. Given the similar hemodynamic reaction over repeated sessions, a single measurement can be used to predict subsequent reactions and to preemptively treat cardiovascular changes without the need to use costly consumables over multiple sessions.