CHEYNA-STOKSA BREATH

From Big Medical Encyclopedia

ChYoYNA — STOKES BREATH -

(J. Cheyne, shotl. doctor, 1777 — 1836; W. Stokes, the Irish doctor, 1804 — 1878) — one of types of periodic breathing which is characterized by the repeating cycles of gradual increase and decrease of amplitude of respiratory excursions and complete cessation of respiratory

movements (apnoea) between such cycles. This type of breath was described for the first time by Cheyn in 1818, and Stokes in 1854 in detail studied.

Duration of cycles of breath and periods of an apnoea (fig.), and also


Fig. The diagrammatic representation of breath of Cheyn — Stokes: series of respiratory movements alternate with the periods of complete cessation of breath (apnoea).

their ratio in various cases are not identical. Short-term breath like Cheyn — Stokes is sometimes observed at children of younger age, at adults, preferential at senile age, during sleep, and also at nek-ry animals during hibernatation. In similar cases uniform breath is easily recovered after awakening or at influence of various external irritants. Stable forms of Ch. — S. of arise at organic lesions of a brain (see) — injuries, strokes, tumors, inflammatory processes; at frustration of cerebral circulation (see); gross violations of metabolism, napr, at acidosis (see), a diabetic coma (see) or uraemias (see); at exogenous intoxications (see); shock (see) and other serious conditions which in most cases are followed by a deep hypoxia of a brain (see the Hypoxia). Long Ch. — S. of or its repeated emergence often is an adverse predictive sign. Duration of the periods of an apnoea progressively increases in such cases, the maximum amplitude of respiratory excursions decreases, and breath can stop completely. Ch.'s transition — S. of in other patol is possible. forms of breath — apneystichesky breath (long delays on a breath), breath like Kussmaul (see Kus-smaul breath), agonal breath (see the Agony), etc.

Ch. is frequent — S. is combined by with undulations of blood pressure (Traube's wave — Goering), pulse rates, periodic change of width of pupils, attacks of a hiccups, etc.

The origins of Ch. — S. of, as well as other types of periodic breathing, in a crust, time are found out insufficiently that it is considerably connected with incompleteness of knowledge of a structurally functional orga-

of a nization of a respiratory center (see) and mechanisms of its activity. A number of researchers considers that Ch. — S. of is the cornerstone decrease in excitability (see) a respiratory center, its lability (see), development of a parabiosis in it (see). Respiratory pauses explain istoshche-niyekhm nervous cells of bulbar structures, and resuming of breath — «rest» and maintenance of neurons during a pause, with increase in their excitability. There is a point of view that Ch. — S. of results from selective decrease in sensitivity of a respiratory center to carbonic acid and periodic vibrations of tension of carbon dioxide gas in blood. Believe also that Ch. — S. of is manifestation of «disturbance of steadiness» and «fight» of processes of excitement and braking in a respiratory center and in other departments of c. N of page Nek-ry researchers connect Ch. — S. by with loss of influence of the highest departments of a brain on a respiratory center or with inadequate reflex influences. Existence of several various mechanisms of development of breath of Cheyn — Stokes is allowed: disorder

of cortical processes and functions of an interstitial brain, primary disturbances at the level of bulbar structures. The opinion is considered the most reasonable that Ch. — S. of can arise at defeat not only structures of a respiratory center, but also other departments of a brain, and also various fiziol. the systems directly or indirectly influencing a respiratory center and the relevant afferent channels.

At Ch.'s emergence — S. treatment first of all shall be directed to a basic disease. Urgent therapeutic events are held for the purpose of elimination of a hypoxia of a brain. Inhalation of pure oxygen and mix of oxygen with carbon dioxide is shown. Besides, enter caffeine, an Euphyllinum, Cordiaminum and Corazolum, strophanthin, in nek-ry cases — small doses of narcotic analgetics (see the Hypoxia, treatment and prevention).

Bibliography: B at about with l and in with to and I am T. V.

Clinical options of breath Cheyn — Stokes, Klin, medical, t. 38, 9,

page 121, 1960; The Multivolume guide to pathological physiology, under the editorship of H. N. Si-rotinina, t. 3, page 70, M., 1966; The Guide to clinical physiology of breath, under the editorship of D. L. Shik and N. I. Kanayev, L., 1980; Safonov V. A., Yefimov V. N. and Chumachenko A. A. Neurophysiology of breath, M., 1980;

With h e r n i and with to N. Page and. lake of Experimentally induced Cheyne — Stokes breathing, Resp. Physiol., v. 37, p. 185, 1979;

Cheyne J. A. case of apoplexy, in which the fleshy part of the heart was converted into fat, Dublin Hosp. Rep., v. 2, p. 216# 1818; Severinghaus J,

W. Patho-physiologic aspects of the regulation of respiration, Bull. Acad. roy. Med. Belg., v. 134, p. 261, 1979; Stokes W. The diseases of the heart and aorta, Dublin, 1854. H. I. Losev.

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