Biot’s Respiration

Definition

Biot’s respiration (ataxic breathing) is an abnormal breathing pattern characterized by irregular periods of rapid, shallow breaths followed by sudden apnea. Unlike Cheyne-Stokes, the depth does not wax and wane predictably.

Causes

• Medullary (brainstem) damage from stroke, tumor, or trauma
• Meningitis with increased intracranial pressure
• Severe opioid overdose
• End-stage neurologic disease

Differentiation from Cheyne-Stokes

Cheyne-Stokes breathing has a predictable crescendo-decrescendo pattern with apnea (seen in CHF, stroke); Biot's is chaotic without predictability (indicates medullary damage).

Nursing Considerations

Biot's respiration is an ominous sign of severe brainstem dysfunction. Assess full neurologic status, GCS, pupils, and vital signs. Prepare for possible intubation and mechanical ventilation. Monitor ICP and administer interventions per protocol.

NCLEX Relevance

A high-yield cue for severe CNS injury. Associate Biot’s with medullary damage.