Theophylline therapy for near-fatal Cheyne-Stokes respiration. A case report.

Abstract

BACKGROUND:

Cheyne-Stokes respiration is characterized by periodic breathing that alternates with hypopnea or apnea.

OBJECTIVE:

To describe the effect of theophylline on near-fatal Cheyne-Stokes respiration.

DESIGN:

Case report.

SETTING:

Tertiary referral center.

PATIENT:

A 48-year-old diabetic woman with a history of three cardiorespiratory arrests, a normal coronary arteriogram, normal left ventricular function, and severe Cheyne-Stokes respiration.

MEASUREMENTS:

Oxygen saturation, intra-arterial blood pressure, central venous pressure, chest wall movement, electrocardiography, electromyography, electroencephalography, electro-oculography, minute ventilation, arterial blood gases, and serum theophylline levels.

RESULTS:

After intravenous administration of 1.2 mg of theophylline at 0.6 mg/kg per hour (serum level, 5.6 microg/mL), both Cheyne-Stokes respiration and oxygen desaturation were markedly attenuated. After infusion of 2.4 mg of theophylline (serum level, 11.6 microg/mL), Cheyne-Stokes respiration resolved completely. No change was seen with placebo. Cheyne-Stokes respiration did not recur during outpatient treatment with oral theophylline.

CONCLUSION:

Theophylline may be a rapid and effective therapy for life-threatening Cheyne-Stokes respiration.

• Authors: C A Pesek, R Cooley, K Narkiewicz, M Dyken, N L Weintraub, V K Somers
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 130 Issue 5 Pg. 427-30 (Mar 02 1999) ISSN: 0003-4819 [Print] United States
• PMID: 10068417 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Bronchodilator Agents
• Theophylline

Topics

• Blood Pressure (physiology)
• Bronchodilator Agents (therapeutic use)
• Cardiopulmonary Resuscitation
• Cheyne-Stokes Respiration (complications, drug therapy, physiopathology)
• Electrocardiography
• Female
• Heart Arrest (etiology, therapy)
• Humans
• Middle Aged
• Theophylline (therapeutic use)