Cheyne–Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary halt in breathing, called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes. It is an oscillation of ventilation between apnea and hyperpnea with a crescendo-diminuendo pattern, and is associated with changing serum partial pressures of oxygen and carbon dioxide.
Cheyne-Stokes respiration and
periodic breathing are the two regions on a spectrum of severity of oscillatory tidal volume. The distinction lies in what is observed at the trough of ventilation: Cheyne-Stokes respiration involves apnea (since apnea is a prominent feature in their original description) while periodic breathing involves hypopnea (abnormally small but not absent breaths).
The pathophysiology of Cheyne-Stokes breathing can be summarized as apnea leading to increased CO2, which causes excessive compensatory hyperventilation that, in turn, causes decreased CO2, which causes apnea, restarting the cycle.
This abnormal pattern of breathing may be seen in patients with heart failure, strokes, traumatic brain injuries, and brain tumors. In the palliative care setting, Cheyne-Stokes breathing may be seen as a patient nears death; patients able to speak after such episodes do not report any distress associated with the breathing, although it is sometimes disturbing to the family.
The syndrome is named after the two physicians who identified it: British physician John Cheyne (1777-1836) and Irish physician, William Stokes (1804-1878).
Adapted from Wikipedia, the free encyclopedia. Internet. Accessed on October 11, 2016.