Document Detail

Cheyne-Stokes respiration: friend or foe?
MedLine Citation:
PMID:  22318163     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Orthopnoea and paroxysmal nocturnal dyspnoea are common entities regularly confronting thoracic physicians, particularly those with an interest in sleep medicine or non-invasive ventilatory support. One major cause is heart failure (HF), usually associated with abnormal lung function tests, and either obstructive or central sleep apnoea with Cheyne-Stokes respiration (CSA-CSR). Whereas obstructive apnoea is considered injurious to the cardiovascular system, the effects of CSA-CSR are less clear and may be a compensatory response to severe HF.
AIM: To determine whether there are compensatory or possibly beneficial aspects caused by CSA-CSR in HF.
METHODS: Literature review.
RESULTS: CSA-CSR can be detrimental in terms of intermittent hypoxaemia, arousals and autonomic dysregulation. However, it is also associated with the beneficial effects of hyperventilation-related increases in end-expiratory lung volume, intrinsic positive airway pressure, assistance to stroke volume, attenuation of excessive sympathetic nervous activity, avoidance of hypercapnic acidosis and finally the provision of periodic rest to fatigue-prone respiratory pump muscles.
CONCLUSIONS: CSA-CSR has physiological features more likely to be compensatory and beneficial than injurious in HF. Some aspects of CSA-CSR are similar to those seen with positive airway pressure.
Matthew T Naughton
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-02-08
Journal Detail:
Title:  Thorax     Volume:  67     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-19     Completed Date:  2012-05-07     Revised Date:  2013-01-28    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  357-60     Citation Subset:  IM    
Department of Allergy, Immunology and Respiratory Medicine, Head, Respiratory and Sleep Medicine Service, Alfred Hospital, Monash University, P.O. Box 315, Prahran, Victoria 3181, Australia.
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MeSH Terms
Cheyne-Stokes Respiration / etiology*,  physiopathology*
Heart Failure / complications*,  physiopathology*
Sleep Apnea Syndromes / etiology*,  physiopathology*
Comment In:
Thorax. 2013 Jan;68(1):106-7   [PMID:  23117975 ]

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