#KYJ Biot’s breathing v Cheyne-Stokes breathing
Part 1 of 2
Chances are, if you’re a nurse you’ve seen a few different pontine breathing patterns in your patients.
In this KnowingYourJargon episode we will discuss two similar abnormal ventilation patterns you may have nursed.
These come from the respiratory control centre located in the Pons in your brain stem.
Let’s start with more familiar territory.
Cheyne Stokes
Cheyne-Stokes breathing is most often seen in end of life situations . Palliative care nurses will attest to this easily recognisable pattern of crescendo /decrescendo breathing.
Shallow breaths followed by deeper and deeper breaths before becoming shallower and shallower until nothing for a few seconds. The pattern repeats over and over.
While it can be seen in wakefulness and obstructive sleep apnoea, it is most commonly seen at end of life stage 4 heart failure and kidney failure. It is the result of fluctuations in blood pH the dominant factor that regulates breathing rate, depth and pattern.
As pH falls the respiratory centre (Pons) increases breathing in attempt to blow off (excrete) CO2 which drops blood pH. This rapid deep breathing over shoots the mark producing alkalosis which is then corrected by making breaths shallow and slowing to apnoea . The process goes back and forth giving rise to a cycle lasting from 30sec to 2 mins.
The condition was named after John Cheyne and William Stokes (of Stokes-Adams fame) the physicians who first described it in the 19th century.
Next we will discuss the rarely seen Biot’s breathing .