Cheyne-Stokes respiration

Cheyne-Stokes respiration Pattern of breathing with gradual increase in depth and sometimes in rate to a maximum, followed by a decrease resulting in apnea. The cycles ordinarily are 30 seconds to 2 minutes in duration, with 5 to 30 seconds of apnea. 

From top down respiration, blood pressure, injection signal, and base line, time in 5 seconds A = 60 mg./kg. chlordan, intravenously B — 6 minutes later, Cheyne-Stokes respiration C = 15 mg./kg. sodium pentothal 1 5 minutes later (respiration restored to normal and lowered blood pressure due to temporary action of pentothal) D = 20 minutes after pentothal injection... 

Physical examination findings may include pulmonary crackles, an S3 gallop, cool extremities, Cheyne-Stokes respiration, tachycardia, narrow pulse pressure, cardiomegaly, symptoms of pulmonary edema (extreme breathlessness, anxiety, sometimes with coughing pink, frothy sputum), peripheral edema, jugular venous distention, hepatojugular reflux, and hepatomegaly. 

Giddiness, tension, anxiety, jitteriness, restlessness, emotional lability, excessive dreaming, insomnia, nightmares, headaches, tremor, withdrawal and depression, bursts of slow waves of elevated voltage in EEC, especially on over-ventilation, drowsiness, difficult concentration, slowness on recall, confusion, slurred speech, ataxia, generalized weakness, coma, with absence of reflexes, Cheyne-Stokes respirations, convulsions, depression of respiratory and circulatory centers, with dyspnea, cyanosis, and fall in blood pressure. 

Hyperpnea Cheyne-Stokes respiration Deep and rapid breathing. Breathing characterized by rhythmic waning and waxing of the depth of respiration, with regularly recurring periods of apnea seen especially in coma resulting from affection of the nervous centers. 

Respiratory Effects. Breathing irregularities including Cheyne-Stokes respiration developed in two persons who fell into cisterns containing copper cyanide or potassium cyanide (Dodds and McKnight 1985 Trapp 1970) or whose hands were exposed to hydrogen cyanide (Potter 1950). The effects reflect the central nervous system toxicity of cyanide. 

With severe intoxication by all routes, an excess of acetylcholine at the neuromuscular junctions of skeletal muscle causes weakness aggravated by exertion, involuntary twitchings, fasciculations, and eventually paralysis. The most serious consequence is paralysis of the respiratory muscles. Effects on the central nervous system include giddiness, confusion, ataxia, slurred speech, Cheyne-Stokes respiration, convulsions, coma, and loss of reflexes. The blood pressure may fall to low levels, and cardiac irregularities, including complete heart block, may occur. ... 

Lanfranchi PA, Braghiroli A, Bosimini E, et al. Prognostic value of nocturnal Cheyne-Stokes respiration in... 

Naughton MT, Liu PP, Bernard DC, et al. Treatment of congestive heart failure and Cheyne-Stokes respiration during sleep by continuous positive airway pressure. Am J Respir Crit Care Med. Jan 1995 151(l) 92-97. 

Overdosage produces cold or clammy skin, hypothermia, severe CNS depression, cyanosis, rapid pulse, and Cheyne-Stokes respirations. 

Staniforth AD, Kinnear WJ, Starling R, Hetmanski DJ, Cowley AJ (1998) Effect of oxygen on sleep quality, cognitive function and sympathetic activity in patients with chronic heart failure and Cheyne-Stokes respiration. Ear Heart J 19 922-928... 

Sin DD, Logan AG, Fitzgerald FS, Liu PP, Bradley TD (2000) Effects of continuous positive airway pressure on cardiovascular outcomes in heart failure patients with and without Cheyne-Stokes respiration. Circulation 102 61-66... 

An 85-year-old woman became gradually toxic (serum lithium 2.9 mmol/1) in a nursing home (168). Despite only conservative management, there was slow but complete resolution of severe neurological symptoms, including coma, fixed pupils, and Cheyne-Stokes respiration. 

A 23-year-old pregnant woman at 39 weeks of gestation developed tonic-clonic seizures and hypothermia after taking excessive heroin intravenously (23). She developed Cheyne-Stokes respiration needing intubation and a cesarean section was performed, after which she developed inappropriate secretion of antidiuretic hormone and acute renal insufficiency. She made a complete recovery. 

Lobeline has peripheral effects similar to those of nicotine, whereas its central activity may be different. It has been associated with nausea, vomiting, headache, tremors, and dizziness. Symptoms caused by overdosage include profuse sweating, paresis, tachycardia, hypertension, Cheyne-Stokes respiration, hypothermia, coma, and death. Large doses are convulsant. 

Pesek CA, Cooley R, Narkiewicz K, Dyken M, Weintraub NL, Somers VK. Theophylline therapy for near-fatal Cheyne-Stokes respiration a case report. Ann Intern Med 1999 130(5) 427-30. 

Paregoric produces CNS depression ranging from drowsiness to coma. These symptoms can be cyclic due to decreased gastric emptying. Respiratory depression occurs and progresses to Cheyne-Stokes respirations, cyanosis, and respiratory arrest. Pulmonary edema can also occur. Cardiac affects are characterized by bradycardia and hypotension. Other symptoms include hypothermia, flaccid skeletal muscles, cold and clammy skin. 

Severe TBI may be accompanied by significant alterations or instability in vital signs, including abnormal breathing patterns (e.g., apnea, Cheyne-Stokes respiration, tachypnea), hypotension, or bradycardia. ABCs indicating hypoxia (i.e., decreased Pa02) or hypercapnia (i.e., increased PaC02) may indicate compromised ventilation. 

Neurological Headache, coma, loss of reflexes, Cheyne-Stokes respiration, seizures, electroencephalogram abnormalities Organophosphate-induced delayed polyneuropathy manifested by flaccidity or paralysis of extremities, paresthesias, footdrop, gait ataxia, spasticity develops 1-2 weeks after exposure Intermediate syndrome 1-4 days after exposure manifested by weakness of proximal limb and respirator muscles, loss of knee reflexes, cranial nerve palsy, death... 

Headache, coma, loss of reflexes, Cheyne-Stokes respiration, seizures, abnormal electroencephalogram findings... 

GA GB GD GF VX Frequent micturition, urinary incontinence. Apprehension, giddiness, insomnia, headache, drowsiness, difficulty concentrating, poor memory, confusion, slurred speech, ataxia, weakness, coma and areflexia, Cheyne-Stokes respiration, convulsions. Fasciculations, easy fatigue, cramps, weakness (including respiratory muscles), paralysis. 

Cheyne-Stokes respiration central supply room corrective septorhinoplasty... 

The symptoms of overdosage are usually somnolent but may be stuporous or comatose and convulsing. Respiratory depression is characteristic the ventilatory rate or tidal volume is decreased, resulting in cyanosis and hypoxia. Pupils, initially pinpoint, may dilate as hypoxia increases. Cheyne-Stokes respiration and apnea may occur. BP falls, and cardiac performance deteriorates, resulting in pulmonary edema and circulatory collapse, unless corrected promptly. Cardiac arrhythmias and conduction delay may be present. 

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