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At least 19 recordsLinked to original sources
PubMed1975

Cheyne-Stokes respiration and sleep: a diurnal polygraphic study.

Thirty-four adult patients with Cheyne-Stokes respiration provided 47 routine EEG records and 24 polygraphic afternoon records. These records were analysed and compared with those of 18 Pickwickian patients previously studied. The main points of difference between these two groups of patients were: the Cheyne-Stokes patients were older and their respiratory periodicity (RP) was not strictly sleep-linked; it could be observed in wakefulness as well as sleep (in that case opening and closing the eyes often did not interrupt the ongoing RP); it tended to disappear in REMS. The main points of resemblance were the frequent appearance of Cheyne-Stokes RP at sleep onset and the presence of occasional ineffective respiratory movements during the crescendo phase of RP in sleep.

Age Factors↗
PubMedDate not supplied

Fluctuating intracranial hypertension due to Cheyne-Stokes respiration.

Cyclically fluctuating intracranial pressure (ICP) with periodic breathing was first described by Nils Lundberg in 1960. While Cheyne-Stokes respiration (CSR) frequently accompanies severe cerebrovascular accidents, it is not commonly appreciated that cycles of severe intracranial hypertension can complicate this abnormal ventilation pattern. We recently treated a patient with a hemorrhagic stroke in whom episodes of elevated ICP were synchronously associated with CSR.

Aged↗
PubMedDate not supplied

[Potentials of hyperbaric oxygenation in correcting central respiratory disorders in ischemic stroke].

Changes in central respiratory disorders under the effect of hyperbaric oxygenation (HBO) were studied in 29 patients in the acute stage of ischemic stroke. Spirography, tetrapolar rheography, and examination of the blood gas composition were carried out. Before HBO was begun, various disorders of the respiratory function were found (hyperventilation syndrome, periodical rhythms: Cheyne-Stokes respiration, alternating respiration, etc.). It was revealed that HBO session causes a normalizing effect on the respiratory function in central disorders of respiration: the Cheyne-Stokes rhythm was replaced at the end of the session by wave-like respiration which is biologically more adequate, the regimen of hyperventilation changed to normoventilation, etc. There was parallel improvement in the indices of central hemodynamics and the blood gas composition.

Acute Disease↗
PubMed1979

Periodic respiration. The capnographic interpretation.

Different type of periodic respiration are difficult to distinguish clinically although their identification may influence the diagnosis, prognosis and treatment. Often other forms of abnormal respiration are mistaken for periodic. Four capnograms are shown illustrating (1) true Cheyne-Stokes respiration, (2) irregular "pseudo-periodic" respiration a) after fentanyl, and b) in the presence of a brain tumour and (3) regular respiration interspersed with deep sighs which was diagnosed clinically as Cheyne-Stokes respiration. A plea is made for the routine use of capnography in order to provide a visual record of respiration.

Carbon Dioxide↗
PubMedDate not supplied

Paroxysmal nocturnal dyspnoea and periodic respiration.

Patterns of breathing at night were recorded in 4 patients with heart-failure. 2 had periodic breathing while awake and in 2 it developed after they fell asleep. In all 4 the phase of hyperventilation disturbed sleep. These cases also illustrate other problems caused by periodic respiration in heart-failure, which range from tiredness during the day to an inability to sleep for more than a few minutes. Nocturnal waking in the hyperventilation phase of Cheyne-Stokes breathing should be differentiated from paroxysmal nocturnal dyspnoea caused by episodes of pulmonary oedema at night.

Aged↗
PubMedDate not supplied

Cardiac and respiratory monitoring of acute stroke patients.

This study evaluates physiologic monitoring as a tool for improved nursing observation of acute stroke patients. Forty-four patients admitted within 48 hours of onset of stroke were monitored using an automated arrhythmia detection system and impedance pneumography. Cardiac arrhythmias were observed in 25 of 44 patients. Three patients with episodes of atrial fibrillation were digitalized and converted to normal sinus rhythm. Respiratory patterns were intermittently abnormal in 39 of 44 patients. The presence of intermittent Cheyne-Strokes respirations or tachypnea was associated with an increased mortality rate. Cardiac monitoring appears to be a useful tool for prompt detection of potentially serious arrhythmias in stroke patients. Respiratory monitoring is useful for detection of abnormalities of respiratory rate and pattern; these abnormalities may serve as an early indicator of change in neurologic status.

Arrhythmias, Cardiac↗
PubMed1979

Apneic spells associated with timolol therapy in a neonate.

A 2-week-old premature child with congenital glaucoma secondary to anterior cleavage syndrome was treated with timolol maleate and cyclocryotherapy. The patient had apneic spells of up to 30 seconds that stopped soon after timolol maleate therapy was discontinued. No apnea was seen before timolol maleate administration, and no further spells were noted after subsequent cyclocryotherapy without timolol maleate treatment. Possible central nervous system toxicity of timol maleate or its metabolic by-products in neonates with immature blood-brain barriers was noted.

Acetazolamide↗
PubMed1975

Abnormal breathing patterns.

In health, breathing is regular and the respiratory rate is sufficiency constant to be useful as a vital sign of health and disease. This regularity depends on a complex interplay of chemical and neural control systems that operate automatically to reset the rate and depth of breathing as changes occur in posture and activity, to adjust the level of ventilation so that changes in gas tensions and pH in the blood and in the brain intersitial fluid are exceedingly modest despite wide swings in metabolic rate and in environmental conditions, and to coordinate ventilation and circulation so that the requirements of individual tissues for O2 delivery and CO2 removal are satisfied. Two broad categories of disorders can result from malfunction of these systems (Table 1): (1) disproportionate ventilation (too high or too low) for the level of metabolic activity, thereby producing severe abnormalities in blood gas tensions or in acid-base balance, and (2) an irregular breathing pattern without eliciting gross changes in blood gas tensions or in acid-base balance. Because of the complexity of the control system, each of these categories represents a final common pathway that can be produced in different ways. In this presentation, we will attempt to describe the general features that characterize the operation of the control system and some new technics that make it possible to trouble-shoot the malfunctioning system in order to identify the mechanism(s) responsible for the abnormality in breathing pattern.

Animals↗
PubMed1978

Aminophylline increases cerebral metabolic rate and decreases anoxic survival in young mice.

In weanling mice treated with pharmacologic doses of aminophylline, the concentrations of adenosine 3',5'-monophosphate and guanosine 3',5'-monophosphate in the brain increased 44 and 36 percent, respectively, and the cerebral metabolic rate was three times that in controls. In neonatal mice, therapeutic doses of aminophylline greatly decreased the rate of anoxic survival in vivo and the duration of gasping of the isolated head. The findings suggest caution in the use of this drug and other methylxanthines in hypoxic human newborns.

Adenine Nucleotides↗
PubMed1977

Oscillation and chaos in physiological control systems.

First-order nonlinear differential-delay equations describing physiological control systems are studied. The equations display a broad diversity of dynamical behavior including limit cycle oscillations, with a variety of wave forms, and apparently aperiodic or "chaotic" solutions. These results are discussed in relation to dynamical respiratory and hematopoietic diseases.

Cheyne-Stokes Respiration↗
PubMed1975

[Combined effects of hypoxia and hypercapnia on the functional state of the respiratory center].

Experiments were conducted on cats under nembutal anesthesia; a study was made of pulse activity of bulbar respiratory neurons, electrical activity of the diaphragm and of the intercostal muscles; pO2, pCO2, pH, arterial blood oxygen saturation were determined in combined action of hypoxia and hypercapnia. When hypoxic gaseous mixture was given for respiration the developing hypocapnia disturbed the discharge rhythmic activity of the respiratory neurons, the respiration acquiring a pathological character of the Cheyne--Stokes type. After addition to the hypoxic gaseous mixture of 2% CO2 the gaseous composition of the arterial blood approached the initial values; this addition prevented the development of hypercapnia and disturbances of rhythmic discharge activity of the respiratory neurons. Addition of 5% CO2 to the hypoxic gaseous mixture produced a negative effect: at first it intensified and then depressed the pulse activity of the respiratory neurons, caused metabolic and respiratory acidosis, and promoted asphyxia.

Animals↗
PubMed1979

Monitoring as anesthesia draws to a close.

The closing phase of anesthesia is defined. Some of the hazards of this period are reported and illustrated by capnograms. It is claimed that the dangers arising at the end of anesthesia are insufficiently appreciated.

Anesthesia↗
PubMed1978

The definition of "Cheyne-Stokes rhythms".

The review of the literature on Cheyne-Stokes respiratory periods reveals enormous variation of the opinions expressed. The original description concerned periodicity characterized by rhythmic changes of respiratory phases and respiratory pauses in a relation of 60 : 15 seconds. In the respiratory phase there were 30 respirations of increasing depths and frequency at the beginning of the phase and decreasing depths and frequency at the end of the phase. Literature data about Cheyne-Stokes respiration comprise a multiplicity of all rhythymic forms. The duration of respiratory cycles varies between 12 and 130 seconds. The relation of the respiratory phase and respiratory pause between 6 : 4 or 75 : 70 seconds, and the number of breaths between 3 and 30 during one respiratory phase. Cheyne-Stokes periods were observed in health subjects as well as in patients with neurological, neurosurgical, cardiac, pulmonary and paediatric diseases. Cheyne-Stokes periods were explained as sequel of prolongation of circulation time between pulmonary alveoli and respiratory centre, through increased sensitivity of the respiratory centre to CO2, diminished sensitivity of the respiratory centre to CO2 and O2-deficit, local blood flow disturbances, section of pathways in the brain stem with disinhibition of basic rhythms, brain immaturity, alterations of consciousness, and respiratory obstructions. Rhythmic changes of the heart beat, of excitability of the heart muscle, of blood pressure, of EEG and of neurological and mental signs were observed. In spite of numerous observations detailed analysis of the respiratory cycle was performed in only a few cases. Major studies are lacking.

Animals↗
PubMed1979

Experimentally induced Cheyne-Stokes breathing.

We have studied the propensity for periodic breathing to occur in cats anaesthetized with pentobarbitone breathing either spontaneously or with the aid of a 'servo-respirator' governed continuously by the efferent phrenic nerve activity. Sustained periodic breathing could be induced increasing 'controller gain', either by increasing the gain of the respirator, or by lung deflation, which reflexly increased controller responses to both hypoxia and hypercapnia. Periodic breathing was potentiated both by hypoxia and by diminishing the central (CO2, H+)-drive by focal cooling at the ventral surface of the medulla, two procedures which increase the relative influence of hypoxic drive. Less hypoxia was needed to produce periodic breathing at high rather than low controller gains. Reducing controller gain to zero by constant artificial respiration always abolished periodic breathing. Periodic breathing was also eradicated when the relative importance of CO2 drive was enhanced by breathing the cats with CO2-enriched gas mixtures or with 100% O2. The results are consistent with theoretical predictions for the occurrence of oscillations in the mechanisms for the chemical control of breathing and indicate that increasing controller gas can produce periodic breathing. The results further emphasize the importance of the (CO2, H+)-drive in preserving ventilatory stability.

Animals↗