The definition of “Cheyne-Stokes rhythms”

Abstract

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.

Algorithms to qualify respiratory data collected during the transport of trauma patients

“…Acute respiratory distress syndrome and serious sleep-related breathing disorder have deleterious effects on the cardiovascular system and are associated with heart failure, artery diseases and lung injuries (Javaheri 2003, Kallet et al 2006, Obenza Nishime et al 2000. Moreover, patterns of respiration, such as alternating respiration (Thomas et al 2004) and Cheyne-Stokes respiration (Lorenz and Ito 1978), have diagnostic value (Isakov et al 1979, Bounhoure et al 2005. Thus, clinicians suggest the continuous monitoring of respiratory status to identify events related to life-threatening respiratory, cardiac and neuromuscular diseases (Burdett-Smith 1997, Folke et al 2003, Mellies et al 2005 and to employ patterns and rate of respiration to evaluate respiratory characteristics during mechanical ventilation (Yang andYang 2002, Lucangelo et al 2005), indexing of cardiac parasympathetic control (Grossman et al 2003) and estimation of trauma severity (Frankema et al 2005).…”

Influence of oxygen supply upon vegetative functions during increased intracranial pressure

“…(1975), showing that the increase of ICP causes an early significant decrease of arterial pO 2 and a significant increase of arterial pCO.2. When the blood gas values were studied at the time of marked increase of RMV in $1 it became clear that the data corresponded to the reference values for cats of Herbert and Mitchell (1971) and that the variation of RMV during increase of ICP cannot be interpreted as a phenomenon aiming at the correction of pathological blood gas values but as a response of cerebral dysregulation leading to pathological respiratory patterns independently from blood-gas parameters 27 Central venous pressure was not influenced by increased intracranial pressure either in animals breathing spontaneously or in animals artificially ventilated. If the CVP were significantly different, the comparison of ICP between both the series could riot be applied, as one has to take into account the fact that ICP is influenced by CVP, particularly in artificially ventilated animals 85…”