13.14: Alterations in Respiration II
There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include increased intracranial pressure and damage to the brain's respiratory center from conditions such as stroke, head trauma, and spinal meningitis.
Cheyne-Stokes respiration begins with slow, shallow breaths that gradually increase in rate and depth. The pattern reverses; breathing slows, becomes shallow, and ends in apnea before resuming. This pattern is observed in patients with cardiac failure, hyponatremia, brain injury, drug overdose, increased intracranial pressure, and renal failure. It can also occur during normal aging or at high altitudes.
Kussmaul's breathing is abnormally deep and rapid but remains consistent in pace. It commonly results from stimulation of the respiratory center due to metabolic acidosis associated with diabetic ketoacidosis.
Hyperventilation is marked by an increased rate and depth of respirations and may lead to hypocarbia. Causes include changes in blood gas concentrations, anxiety, exercise, and metabolic acidosis.
Hypoventilation features shallow and irregular breathing, often caused by an overdose of certain anesthetic agents, prolonged bed rest, or conscious splinting of the chest to avoid respiratory pain.
In summary, a thorough understanding of these respiratory patterns, their characteristics, and associated causes is crucial for healthcare professionals to evaluate and manage patients with respiratory issues effectively.
