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Cheyne-Stokes respiration: friend or foe?
MedLine Citation:
PMID:  22318163     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundOrthopnoea 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.AimTo determine whether there are compensatory or possibly beneficial aspects caused by CSA-CSR in HF.MethodsLiterature review.ResultsCSA-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.ConclusionsCSA-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.
Authors:
Matthew T Naughton
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-8
Journal Detail:
Title:  Thorax     Volume:  -     ISSN:  1468-3296     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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