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Cheyne-Stokes respiration revisited: controversies and implications
Critical Care Medicine
|October 1, 1984
Summary
Cheyne-Stokes respiration (CSR) involves periodic breathing changes, often linked to heart and neurological conditions. Understanding its respiratory control mechanisms is key, though mild forms may occur in healthy individuals during sleep.
Area of Science:
- Physiology
- Respiratory Control
- Sleep Medicine
Background:
- Cheyne-Stokes respiration (CSR) is characterized by periodic breathing, often associated with cardiac and neurological diseases.
- The underlying mechanisms of CSR, particularly the interplay between cardiac and neurological factors, remain a subject of debate.
- The respiratory control system can be modeled as a chemostat involving controllers, controlled gas tensions, and feedback loops.
Purpose of the Study:
- To investigate the physiological basis of periodic breathing alterations in Cheyne-Stokes respiration (CSR).
- To explore the relative importance of cardiac versus neurological mechanisms in the genesis of CSR.
- To understand the implications of altered respiratory control system stability in CSR.
Main Methods:
- Analysis of periodic crescendo-decrescendo alterations in tidal volume during Cheyne-Stokes respiration.
- Review of existing literature and models of respiratory control, including the chemostat model.
- Examination of factors influencing respiratory control system stability, such as circulation time and gas tension dependencies.
Main Results:
- Disturbances in the respiratory control system, potentially due to prolonged circulation time or altered O2/CO2 dependency, can lead to CSR.
- While historically viewed as a sign of serious illness, mild CSR is increasingly identified in healthy individuals, particularly during sleep.
- Mild periodic breathing often requires no intervention, though treatments like oxygen or CO2 administration can abolish it.
Conclusions:
- The interplay between cardiac and neurological factors significantly influences the stability of the respiratory control system in CSR.
- The presence of mild periodic breathing, especially during sleep, may not indicate severe underlying pathology.
- Further research into the nuances of respiratory control in CSR is warranted to differentiate between pathological and physiological variations.
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