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COMA-RESPIRATORY PATTERNS

Neurology

COMA-RESPIRATORY PATTERNS

1. Cheyne-Stokes respiration - periods of hyperventilation alternating with apnea. Occurs in bilateral cerebral disease, impending
herniation, and brainstem lesions; it can also be due to metabolic causes.

2. Apneustic breathing is characterized by a series of slow, deep inspirations, each one held for 30sec or longer, after which the air is expelled by elastic recoil of the lungs, followed by an apneic pause. RR is ~ 1.5/min. It is due to a lesion of the lower pons.

3. Ataxic breathing is very irregular and typically indicates a lesion of the medulla.

4. Central neurogenic hyperventilation - lesions of the lower midbrain-upper pontine tegmentum cause central neurogenic hyperventilation, which produces an increase in the rate and depth of respiration resulting in advanced respiratory alkalosis.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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