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Theophylline therapy for near-fatal Cheyne-Stokes respiration. A case report
C A Pesek1, R Cooley, K Narkiewicz
1University of Iowa, Iowa City 52242-1081, USA.
Background:
Cheyne-Stokes respiration is characterized by periodic breathing that alternates with hypopnea or apnea.
Objective:
To describe the effect of theophylline on near-fatal Cheyne-Stokes respiration.
Design:
Case report.
Setting:
Tertiary referral center.
Patient:
A 48-year-old diabetic woman with a history of three cardiorespiratory arrests, a normal coronary arteriogram, normal left ventricular function, and severe Cheyne-Stokes respiration.
Measurements:
Oxygen saturation, intra-arterial blood pressure, central venous pressure, chest wall movement, electrocardiography, electromyography, electroencephalography, electro-oculography, minute ventilation, arterial blood gases, and serum theophylline levels.
Results:
After intravenous administration of 1.2 mg of theophylline at 0.6 mg/kg per hour (serum level, 5.6 microg/mL), both Cheyne-Stokes respiration and oxygen desaturation were markedly attenuated. After infusion of 2.4 mg of theophylline (serum level, 11.6 microg/mL), Cheyne-Stokes respiration resolved completely. No change was seen with placebo. Cheyne-Stokes respiration did not recur during outpatient treatment with oral theophylline.
Conclusion:
Theophylline may be a rapid and effective therapy for life-threatening Cheyne-Stokes respiration.
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