Cheyne-Stokes respiration: causes, pathogenesis, treatment

Cheyne-Stokes breathing received such a name in honor of the two doctors. What is their merit? They first told the world about this kind of abnormal breathing, which is also called the Cheyne-Stokes syndrome. Previously, nothing was known about him.

How is this syndrome?

Breathing is characterized by a periodicity of breaths, between which there are stops. At the first stage there is a short break, then the dyspnoea phase begins. It lasts from a couple of seconds to a minute, and initially there is a very quiet shallow breathing, which quickly becomes deeper and noisier and reaches a critical point in the fifth-seventh breath. Then it approximately so decreases. It ends with another short stop in the breath. And so on a circle. Cheyne-Stokes breathing is very dangerous.

Periodic respiration in animals

This syndrome occurs in both humans and animals, with the latter more often. Therefore, it is necessary to give them due attention. In diseased animals, a slow increase in the amplitude of inhalations (up to significant hyperpnoea) occurs with a further decrease in them to a pause (apnea). Then again begin to build up respiratory movements. And they end again with apnea, the duration of which is in the range of 30 to 45 seconds. After that, everything repeats itself.

Causes of the syndrome, alternating respiration

This type of periodic respiration is usually observed in animals with such ailments, as the release of blood into the medulla oblongata, petechial fever, all kinds of poisoning, uremia. These pathologies also cause it. Cheyne-Stokes breathing, the causes of which you now know, is a serious violation requiring medical attention. During the stop, patients with difficulty navigate in space or completely lose consciousness. However, with the resumption of breaths, it becomes better for them. There is also information about another type of pathological breathing. It is characterized exclusively by intercalary deep breaths, called peaks. The Cheyne-Stokes Syndrome, during which intercalary breaths are observed between a pair of typical phases of dyspnea, is called alternating respiration. It is rare. The usual Cheyne-Stokes breathing is observed more often. And this is an irrefutable fact. Sometimes there is an abnormal alternating breath, when every second wave is more and more superficial. This is very similar to another disease, namely, an alternating change in the activity of the heart. There is information about the mutual transitions of recurrent dyspnoea, which is of a paroxysmal nature, and the Cheyne-Stokes syndrome. However, apparently, this is a rarity.

Pathogenesis

It is believed that the Cheyne-Stokes breathing almost always signals the hypoxia of the brain and other ailments of gray matter, as well as its shells. In addition, it can appear with heart failure and uremia. The mechanism of the onset of the Cheyne-Stokes syndrome has not been sufficiently studied. Some scientists explain it as follows. When hypoxia occurs, the subcortical formations and cells of the cerebral cortex become oppressed, therefore, a pause occurs in the respiration, a loss of consciousness occurs, and the functioning of the vasomotor center is disrupted. But chemoreceptors even in this situation can still respond to the ongoing changes in the concentration of gases in the blood. Cheyne-Stokes breathing causes a number of disorders in the patient's body. And it's very scary. Why is the respiratory center re-activated? This is facilitated by a sharp increase in the sending of impulses from chemoreceptors, direct exposure to centers of significant carbon dioxide content, as well as stimuli from baroreceptors. All this is due to a decrease in pressure. Thus, breathing is restored. Its renewal entails oxygenation of the blood, which reduces hypoxia of the brain, and also improves the activity of the neurons of the vasomotor center.

At this stage, one can observe deeper breathing, clarity of consciousness, normal pressure, good filling of the heart. Ventilation increases, resulting in an increase in oxygen tension in the arterial blood. What happens with carbon dioxide? Its voltage, on the contrary, decreases. These processes entail a decrease in the chemical, as well as reflex stimulation of the respiratory center, the functioning of which begins to slow down, - apnea occurs.

Cheyne-Stokes breathing: treatment

When this syndrome occurs, it is necessary to enter the "Aminophylline" vein. In the event that the large dosages of this medication do not contribute to the expansion of the cerebral vessels and the normalization of the patient's well-being, it is necessary to inject a drug "Metrazol", which will affect the respiratory center. He really can help. While the patient is ill, you must definitely be with him. And it must be remembered that only a doctor can get the unfortunate out of this state. This is not the case when you can cope with the disease on their own.