China
Africa
Explore chapters and articles related to this topic
The patient with acute neurological problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Cheyne–Stokes breathing: a cyclical pattern of rapid breathing becoming progressively slower and shallower until apnoea occurs. The patient usually starts breathing again spontaneously, but may be stimulated to breathe by tactile stimulation if apnoea is prolonged. This respiratory pattern is associated with widespread cortical lesions and thalamic dysfunction. Apnoea is an important observation and should be reported. Non-invasive respiratory monitoring and support is indicated if apnoea is frequent or prolonged.
C
Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Cheyne, John (1777–1836) Physician from Dublin and the son of a surgeon, who entered Edinburgh University at the age of 15 years. He studied anatomy with Charles Bell (1774–1842), and wrote his first book Essays on the Diseases of Children in 1801. He wrote an early monograph on laryngology, Pathology of the Membrane of the Larynx and Bronchia in 1809. He described acute hydrocephalus in 1808, and Cheyne-Stokes breathing, which occurred in apoplexy or stroke, in 1818. See Cheyne-Stokes breathing.
The patient with acute neurological problems
Published in Ian Peate, Helen Dutton, Acute Nursing Care, 2014
Cheyne–Stokes breathing: a cyclical pattern of rapid breathing becoming progressively slower and shallower until apnoea occurs. The patient usually starts breathing again spontaneously but may be stimulated to breathe by tactile stimulation if apnoea is prolonged. This respiratory pattern is associated with widespread cortical lesions and thalamic dysfunction. Apnoea is an important observation and should be reported. Non-invasive respiratory monitoring is indicated if apnoea is frequent or prolonged.
Developments in treating the nonmotor symptoms of stroke
Published in Expert Review of Neurotherapeutics, 2020
Sleep‐disordered Breathing is the most common sleep disorder after stroke and includes obstructive sleep apnea (OSA) and central sleep apnea (CSA). The latter resembles Cheyne–Stokes breathing. Sleep-disordered breathing is characterized by night‐time symptoms of excess respiratory noises such as snoring, irregular breathing, sleep-onset insomnia, shortness of breath, palpitations, nocturia, agitated sleep and daytime symptoms of sleepiness, headaches, and impaired concentration and memory [85]. OSA can contribute to post-stroke fatigue. Risk factors for the development of OSA and CSA include central obesity, increased age, male sex, and neck circumference [85]. These disorders are diagnosed with polysomnography. CSA is most common after bilateral strokes, strokes associated with disturbed levels of consciousness, or strokes accompanied by heart failure [40].
User Compliance and Behavioral Adaptation Associated With Supine Avoidance Therapy
Published in Behavioral Sleep Medicine, 2018
Daniel Levendowski, David Cunnington, John Swieca, Philip Westbrook
Treatment outcomes in patients with obstructive sleep apnea (OSA) are often limited by poor compliance with prescribed management strategies. Motivational enhancement education was recently shown to affect behavior and improve outcomes for the treatment of OSA with continuous positive airway pressure (CPAP; Aloia, Arnedt, Strand, Millman, & Borrelli, 2013; Dantus, Winck, & Figueiredo-Braga, 2015; Lai, Fong, Lam, Weaver, & Ip, 2014). A potentially more widespread behavioral approach for the treatment of OSA would be to limit supine sleep, given the vast majority (i.e., 55%–87%) of those with OSA studied in the current era are at least twice as severe when back-sleeping than when side-sleeping (Levendowski, Seagraves, Popovic, & Westbrook, 2014; Oksenberg & Gadoth, 2014; Oksenberg, 2014; Ravesloot, van Maanen, Dun, & de Vries, 2013; Ravesloot, Frank, Verhagen, de Lange, & de Vries, 2015). Although positional therapy effectiveness has traditionally been limited to in those with mild to moderate positional OSA (POSA; Jokic, Klimaszewski, Crossley, Sridhar, & Fitzpatrick, 1999; Permut et al., 2010; van Maanen et al., 2013) favorable outcomes have also been reported in those with severe POSA so long as the patient stays off his or her back (Levendowski et al., 2014). It has also been demonstrated that supine avoidance reduces Cheyne-Stokes breathing in heart failure patients with central sleep apnea (Joho, Oda, Hirai, & Inoue, 2010; Soll et al., 2009) and increases the therapeutic response when combined with other OSA therapies (Dieltjens et al., 2015; Lee et al., 2011). Thus, the majority of patients with sleep apnea would receive therapeutic benefit if they could be behaviorally trained to avoid supine sleep.
Diagnosis and management of central sleep apnea syndrome
Published in Expert Review of Respiratory Medicine, 2019
Sébastien Baillieul, Bruno Revol, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Renaud Tamisier, Jean-Louis Pépin
Cheyne-Stokes breathing (CSB) is the stereotypical breathing pattern of CSA in CHF. CSB is characterized by repetitive, cyclic, waxing and waning changes in tidal volume interspersed by central apnea with a prolonged cycle time (from 45 to 75 seconds) [9,22]. CSA in CHF arises from three determinant factors: low cardiac output (increased circulation delay, dampening in feedback gain), high sympathetic activation and pulmonary congestion [9,22] triggering hyperventilation, which decreases PaCO2 to below the apneic threshold. Chemosensitivity (higher controller gain, leading to high loop gain) is involved in the pathogenesis of CSA and the typical periodic breathing of CSB [9,22]. Cardiac output, reflected by the speed of the feedback signal from plant back to controller, is the key determinant of the length and duration of breathing instability in this pathology. In patients with CHF with left ventricular dysfunction and CSA, the number and duration of central apneas increase during the late hours of sleep [28]. By studying the pattern of hyperpnea in the CSB cycle, Perger et al. [29] have shown that a negative hyperpnea pattern (when end-expiratory lung volume falls below functional residual capacity, indicative of marked activation of the expiratory muscles, and resulting in a significant increase in expiratory intrathoracic pressure) was associated with worse cardiac function compared to patients with a positive hyperpnea pattern (when end-expiratory lung volume remains at or above functional residual capacity, resulting in a smaller increase in expiratory intrathoracic pressure compared to the negative hyperpnea pattern). They further hypothesized that a negative hyperpnea pattern and the resulting increase in intrathoracic pressure may serve to support cardiac function during expiration (in terms of stroke volume) and may unload weak inspiratory muscles in the initial phase of inspiration, providing arguments for a potential adaptive role of CSB in HfrEF .