Apneustic breathing

Apneustic breathing is a type of abnormal respiration characterized by deep, gasping inspiration with a pause at full inspiration followed by a partial, insufficient release. This pattern of breathing is often seen in patients with certain types of neurological disorders, particularly those affecting the lower pons and upper medulla of the brainstem.

Etiology

Apneustic breathing is typically caused by damage to the pons, a part of the brainstem that plays a key role in respiration. This damage can be due to a variety of causes, including stroke, trauma, tumor, or neurodegenerative disease. In some cases, apneustic breathing may also be seen in patients with severe brain damage or those who are in a coma.

Pathophysiology

The exact mechanism of apneustic breathing is not fully understood. However, it is believed to be related to a disruption in the normal balance of inhibitory and excitatory signals in the respiratory centers of the brainstem. In particular, damage to the pons may disrupt the normal inhibitory signals sent by the pneumotaxic center, leading to prolonged inspiration.

Clinical Features

Patients with apneustic breathing typically present with a distinctive pattern of respiration. This includes a deep, gasping inspiration followed by a pause at full inspiration, and then a partial, insufficient release. This pattern can be quite distressing for the patient and may lead to significant impairment in gas exchange and oxygenation.

Management

The management of apneustic breathing primarily involves treating the underlying cause. This may include medical or surgical treatment for conditions such as stroke, trauma, or tumor. In some cases, supportive measures such as oxygen therapy or mechanical ventilation may be required to maintain adequate oxygenation.

See Also

• Cheyne-Stokes respiration
• Biot's respiration
• Kussmaul breathing