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Cheyne-Stokes respiration
ICD-10 R06.3
ICD-9 786.04
MeSH D002639

Cheyne-Stokes respiration (pronounced /ˈtʃeɪnˈstoʊks/), also known as periodic breathing is an abnormal pattern of breathing characterized by oscillation of ventilation between apnea and tachypnea with a crescendo-decrescendo pattern in the depth of respirations, to compensate for changing serum partial pressures of oxygen and carbon dioxide.

It is caused by damage to respiratory centers,[1] and is also characteristic of newborns with immature respiratory systems. In the second case however it is a symptom of developmental immaturity and not of a damaged or defective cardiopulmonary system.

Contents

History

The condition was named after John Cheyne and William Stokes, the physicians who first described it in the 19th century. [2][3]

Associated conditions

This abnormal pattern of breathing, in which breathing is rapid for a period and then absent for a period, can be seen in patients with heart failure,[4][5] strokes, traumatic brain injuries and brain tumors. In some instances, it can occur in otherwise healthy people during sleep at high altitudes. It can occur in all forms of toxic metabolic encephalopathy.[6] It is a symptom of carbon monoxide poisoning, along with syncope or coma. This type of respiration is also often seen after morphine administration.

Hospice personnel often document the presence of Cheyne-Stokes breathing as a patient nears death, and report that patients able to speak after such episodes do not report any distress associated with the breathing, although it is sometimes disturbing to the family.

Related patterns

Cheyne-Stokes respirations are not the same as Biot's respirations ("cluster breathing"), in which groups of breaths tend to be similar in size.

They differ from Kussmaul respirations in that the Kussmaul pattern is one of consistent very deep breathing at a normal or increased rate.

References

  1. ^ Cheyne-Stokes respiration at Dorland's Medical Dictionary
  2. ^ J. Cheyne: A case of apoplexy in which the fleshy part of the heart was converted into fat. Dublin Hospital Reports, 1818, 2: 216-223. Reprinted in F. A. Willius & T. E. Keys: Cardiac Classics, 1941, pp. 317-320
  3. ^ William Stokes: Fatty degeneration of the heart. In his: The Diseases of the Heart and Aorta. Dublin, 1854, pp. 320-327.
  4. ^ Lanfranchi PA, Braghiroli A, Bosimini E, et al. (March 1999). "Prognostic value of nocturnal Cheyne-Stokes respiration in chronic heart failure". Circulation 99 (11): 1435–40. PMID 10086966. http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=10086966.  
  5. ^ Brack T, Thüer I, Clarenbach CF, et al. (November 2007). "Daytime Cheyne-Stokes respiration in ambulatory patients with severe congestive heart failure is associated with increased mortality". Chest 132 (5): 1463–71. doi:10.1378/chest.07-0121. PMID 17646230. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=17646230.  
  6. ^ The Diagnosis of Stupor and Coma by Plum and Posner, ISBN 0195138988







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