Cheyne-Stokes Respiration

Definition

Cheyne-Stokes respiration is a cyclical breathing pattern characterized by periods of hyperventilation (increasing and then decreasing depth) alternating with periods of apnea lasting 5 to 30 seconds.

Causes

• Severe congestive heart failure
• Stroke and brain injury
• Uremia and metabolic encephalopathy
• End-of-life (imminent death)
• High altitude
• Opioid effect

Mechanism

Delayed feedback between pulmonary CO2/O2 changes and central respiratory drive produces the oscillation pattern, often reflects poor cerebral perfusion.

Nursing Considerations

Assess for underlying cause; treat CHF, correct electrolytes, manage ICP. In end-of-life, Cheyne-Stokes is an expected finding indicating approaching death. Reassure family that the patient is not suffering. Provide comfort measures, oral care, and a calm environment.

NCLEX Relevance

Differentiate from Biot's (chaotic, no pattern). Cheyne-Stokes is often a pre-terminal sign.