Cheyne Stokes Breathing Definition:
A common cause of death in children and young adults is called Cheyne-Stokes respiration (CSP). CSP occurs when there is a blockage of the lungs’ airways due to abnormal development or injury. The airway becomes inflamed causing the patient’s chest to rise up while they breathe.
When the patient collapses, their body falls back down resulting in death.
The term “cheney” means “to fill” and “stokes” means “air.”
Wikipedia defines it thusly:
CSP is a rare condition that results from a blockage of the upper airways caused by trauma or other abnormalities. The most common form of CSP is known as primary pulmonary hypertension (PPH), which occurs in infants and young children. PPH is characterized by rapid heart rate, high blood pressure, low oxygen saturation, cyanosis, vomiting and diarrhea.
In severe cases, the child may die within hours.
In children with CSP, the airways become inflamed and swollen making them difficult to open. If not treated immediately, these patients will suffer from life-threatening complications such as respiratory failure and cardiac arrest. The disease is usually fatal if left untreated.
The exact cause of CSP is not known, but it is believed to be caused by a combination of factors. Some of these factors may include:
Trauma to the lungs
Infection
Airway anomalies
Heart disease
Pulmonary hypertension
Tobacco smoke
Some studies have suggested that CSP may also be caused by a lack of serotonin, a chemical that carries messages from the brain to other parts of the body. The blockage of airways may be caused by an overgrowth of smooth muscle in the walls of the airways.
Because the exact cause of CSP is unknown, there is currently no known way to prevent CSP. However, treatment for the disease focuses on relieving the symptoms and making the patient as comfortable as possible.
There are two types of CSP: primary and secondary.
In primary CSP, the blockage of the airways is believed to be caused by an overgrowth of smooth muscle in the walls of the airways. Other causes of primary CSP are not known and this type of CSP occurs in infants and young children. In some cases, the cause is unknown.
In secondary CSP, the airway blockage is caused by trauma or other types of injuries such as infection or scarring.
A diagnosis for CSP is usually made by listening to the patient’s breathing with a stethoscope. Chest x-rays may also be used to confirm the presence of CSP. In some cases, a tracheoscopy may be necessary to visualize the patient’s upper airways.
The treatment for CSP varies depending on the cause. In most cases of primary CSP, surgery is usually not an option because the airway blockage is severe and inoperable. The goal of treatment is to improve the patient’s comfort until they die.
For patients with secondary CSP, treatment may include:
Oxygen therapy
Bronchodilators (drugs that dilate the airways)
Vasodilators (drugs that dilate blood vessels)
Diuretics (drugs that increase urination) for patients who are suffering from high blood pressure
Pulmonary vasodilators (drugs that dilate lung blood vessels)
Surgery to remove the blockage in the airway
If a patient has suffered severe brain damage, a tracheostomy may be necessary to make sure the patient is getting enough oxygen.
In some cases, if a patient has severe airway blockage that cannot be treated with drugs or surgery, a tracheotomy may be performed. A tracheotomy involves making an incision in the patient’s throat so that a tube can be inserted directly into the windpipe to support breathing.
Sources & references used in this article:
Cheyne-Stokes breathing: an instability in physiologic control by NS Cherniack, GS Longobardo – New England Journal of …, 1973 – Mass Medical Soc
Adaptive servo-ventilation in patients with idiopathic Cheyne-Stokes breathing by K Banno, K Okamura, MH Kryger – Journal of Clinical Sleep …, 2006 – jcsm.aasm.org
Cheyne-Stokes respiration in patients with cardiac enlargement and prolonged circulation time by WW Pryor – Circulation, 1951 – Am Heart Assoc
The neurologic basis of Cheyne-Stokes respiration by HW Brown, F Plum – The American Journal of Medicine, 1961 – amjmed.com
Cerebral circulation and function in Cheyne-Stokes respiration by HR Karp, HO Sieker, A Heyman – The American journal of medicine, 1961 – Elsevier
