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Rapid Regular Respiration in Unconscious Patients

Rapid Regular Respiration in Unconscious Patients Abstract • Respiratory frequency has been studied by strain gauge and impedance pneumography in a group of unconscious patients suffering from a variety of medical conditions, and has been compared with breathing in control subjects during wakefulness and sleep. Seventeen of 25 comatose patients had breathing patterns amenable to computerized statistical analysis of respiratory rate which demonstrated abnormalities in all patients studied. Unconscious patients breathed more rapidly and regularly than controls. Rapidity of respiration was not consistently associated with any specific central nervous system lesion, and was usually accompanied by coexistent pulmonary disease. Increasing regularity of respiration correlated well with deepening of coma and accurately reflected ultimate outcome even when other clinical signs were unchanging. References 1. Rout MW, Lane DJ, Wollner L: Prognosis in acute cerebrovascular accidents in relation to respiratory pattern and blood gas tensions . Br Med J 3:7-9, 1971.Crossref 2. Lee MC, Klassen AC, Resch JA: Respiratory pattern disturbances in ischemic cerebral vascular disease . Stroke 5:612-616, 1974.Crossref 3. Plum F, Swanson AG: Central neurogenic hyperventilation in man . Arch Neurol Psychiatry 81:535-549, 1959.Crossref 4. Plum F: Neurological integration of behavioural and metabolic control of breathing , in Porter R (ed): Breathing: Hering-Breuer Centenary Symposium . London, J&A Churchill Ltd, 1970, pp 159-174. 5. Plum F: Hyperpnea, hyperventilation and brain dysfunction . Ann Intern Med 76:328, 1972.Crossref 6. Plum F, Posner JB: Diagnosis of Stupor and Coma , ed 2. Philadelphia, FA Davis Co, 1972. 7. Smalhout B: Central respiratory disorders , in Vinken PJ, Bruyn GW (ed): Handbook of Clinical Neurology . Amsterdam, North Holland Publishing Company, 1969, vol 1, pp 665-666. 8. North JB, Jennett S: Abnormal breathing patterns associated with acute brain damage . Arch Neurol 31:338-344, 1974.Crossref 9. Wade DL: Movements of the thoracic cage and diaphragm in respiration . J Physiol (Lond) 124:193-212, 1954. 10. North JB, Jennett S: Impedance pneumography for the detection of abnormal breathing patterns associated with brain damage . Lancet 2:212-213, 1972.Crossref 11. Rechtschaffen A, Kales A: A Manual of Standard Terminology, Techniques and Scoring System for Sleep Stages of Normal Human Subjects. US Government Printing Office, 1968. 12. Fisher CM: The neurological examination of the comatose patient . Acta Neurol Scand 45( (suppl 36) ):1-56, 1969.Crossref 13. Jennett WB, Plum F: The persistent vegetative state: A syndrome in search of a name . Lancet 1:734-737, 1972.Crossref 14. Sambrook MA, Hutchinson EC, Aber GM: Metabolic studies in subarachnoid hemorrhage and strokes . Brain 96:171-190, 1973.Crossref 15. Trenchard D, Gardner D, Guz A: Role of pulmonary vagal afferent nerve fibres in the development of rapid shallow breathing in lung inflammation . Clin Sci 42:251-263, 1972. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Rapid Regular Respiration in Unconscious Patients

Archives of Neurology , Volume 33 (5) – May 1, 1976

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1976.00500050042008
Publisher site
See Article on Publisher Site

Abstract

Abstract • Respiratory frequency has been studied by strain gauge and impedance pneumography in a group of unconscious patients suffering from a variety of medical conditions, and has been compared with breathing in control subjects during wakefulness and sleep. Seventeen of 25 comatose patients had breathing patterns amenable to computerized statistical analysis of respiratory rate which demonstrated abnormalities in all patients studied. Unconscious patients breathed more rapidly and regularly than controls. Rapidity of respiration was not consistently associated with any specific central nervous system lesion, and was usually accompanied by coexistent pulmonary disease. Increasing regularity of respiration correlated well with deepening of coma and accurately reflected ultimate outcome even when other clinical signs were unchanging. References 1. Rout MW, Lane DJ, Wollner L: Prognosis in acute cerebrovascular accidents in relation to respiratory pattern and blood gas tensions . Br Med J 3:7-9, 1971.Crossref 2. Lee MC, Klassen AC, Resch JA: Respiratory pattern disturbances in ischemic cerebral vascular disease . Stroke 5:612-616, 1974.Crossref 3. Plum F, Swanson AG: Central neurogenic hyperventilation in man . Arch Neurol Psychiatry 81:535-549, 1959.Crossref 4. Plum F: Neurological integration of behavioural and metabolic control of breathing , in Porter R (ed): Breathing: Hering-Breuer Centenary Symposium . London, J&A Churchill Ltd, 1970, pp 159-174. 5. Plum F: Hyperpnea, hyperventilation and brain dysfunction . Ann Intern Med 76:328, 1972.Crossref 6. Plum F, Posner JB: Diagnosis of Stupor and Coma , ed 2. Philadelphia, FA Davis Co, 1972. 7. Smalhout B: Central respiratory disorders , in Vinken PJ, Bruyn GW (ed): Handbook of Clinical Neurology . Amsterdam, North Holland Publishing Company, 1969, vol 1, pp 665-666. 8. North JB, Jennett S: Abnormal breathing patterns associated with acute brain damage . Arch Neurol 31:338-344, 1974.Crossref 9. Wade DL: Movements of the thoracic cage and diaphragm in respiration . J Physiol (Lond) 124:193-212, 1954. 10. North JB, Jennett S: Impedance pneumography for the detection of abnormal breathing patterns associated with brain damage . Lancet 2:212-213, 1972.Crossref 11. Rechtschaffen A, Kales A: A Manual of Standard Terminology, Techniques and Scoring System for Sleep Stages of Normal Human Subjects. US Government Printing Office, 1968. 12. Fisher CM: The neurological examination of the comatose patient . Acta Neurol Scand 45( (suppl 36) ):1-56, 1969.Crossref 13. Jennett WB, Plum F: The persistent vegetative state: A syndrome in search of a name . Lancet 1:734-737, 1972.Crossref 14. Sambrook MA, Hutchinson EC, Aber GM: Metabolic studies in subarachnoid hemorrhage and strokes . Brain 96:171-190, 1973.Crossref 15. Trenchard D, Gardner D, Guz A: Role of pulmonary vagal afferent nerve fibres in the development of rapid shallow breathing in lung inflammation . Clin Sci 42:251-263, 1972.

Journal

Archives of NeurologyAmerican Medical Association

Published: May 1, 1976

References