Cheyne-Stokes respiration caused by delayed CO2 feedback

One proposed (but unvalidated) explanation is that the respiratory control centre has a delayed recognition of changes in PaCO2. It therefore sequentially overshoots and undershoots in its response. Cheyne-Stokes respiration has been observed in multiple conditions, including various types ...

In the first figure of our 1975 paper, there is C–SR when the CO2 is very high but only the oxygen oscillates. Certainly, ventilation is abruptly reduced with sleep. That was described in 1958 by Robin et al. [11] and Guntheroth in 1965 [12]. In 2006, Cherniack and Longobardo [13] reviewed mathematical models of C–SR, and concluded that C–SR frequently is a form of instability in the feedback control caused by increased controller and plant gains.

Cheyne–Stokes breathing is abolished by inhalation of CO2 (increasing the Pco2 over the apneic point) but not by inhalation of oxygen.88 · A host of factors that might explain Cheyne–Stokes ventilatory oscillations has been addressed experimentally and clinically.

The time from the breath with the minimal end tidal fraction of CO2 (FETCO2) during hyperpnea until the onset of apnea correlated strongly with the lung to ear circulation time (LECT) (r2 = 0.90, p < 0.0001), a measure of lung to carotid body circulatory delay.

However Cheyne-Stokes respiration (C-SR) can also occur in healthy individuals with sleep, and was demonstrated in 1908 with voluntary hyperventilation, followed by apnea that Haldane blamed on hypoxia, subsequently called post-hyperventilation apnea. Additional theories explaining C-SR did not appear until 1954, based on control theory, specifically a feed-back regulator controlling CO(2).

The pattern is confirmed on polysomnography (PSG), which demonstrates cyclic variation in airflow and respiratory effort accompanied by oscillating oxygen saturation (see Image. Polysomnography of Cheyne-Stokes Respiration With Labeled Apnea Length, Circulation Time). In mechanically ventilated individuals, the same cyclical pattern may be visible as oscillations in tidal volume and minute ventilation on ventilator waveforms.

Cheyne-Stokes respiration is a disorder characterised by recurrent central apnoeas during sleep alternating with a crescendo-decrescendo pattern of tidal volume.1 ,2 It is often observed in patients with congestive heart failure, usually during stages 1 and 2 non-REM sleep when ventilation ...

Cheyne‐Stokes respiration (CSR) is a form of periodic breathing in which central apneas and hypopneas alternate with periods of hyperventilation, producing a waxing and waning pattern of tidal volume.

Causes may include heart failure, kidney failure, narcotic poisoning, intracranial pressure, and hypoperfusion of the brain (particularly of the respiratory center). The pathophysiology of Cheyne–Stokes breathing can be summarized as apnea leading to increased CO2 which causes excessive ...