Catherine A. Pesek, DO; Ryan Cooley, MD; Krzysztof Narkiewicz, MD, PhD; Mark Dyken, MD; Neal L. Weintraub, MD; Virend K. Somers, MD, PhD
Pesek CA, Cooley R, Narkiewicz K, Dyken M, L. Weintraub N, Somers VK. Theophylline Therapy for Near-Fatal Cheyne–Stokes Respiration: A Case Report. Ann Intern Med. 1999;130:427-430. doi: 10.7326/0003-4819-130-5-199903020-00014
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Published: Ann Intern Med. 1999;130(5):427-430.
Cheyne–Stokes respiration is characterized by periodic breathing that alternates with hypopnea or apnea.
To describe the effect of theophylline on near-fatal Cheyne–Stokes respiration.
Tertiary referral center.
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.
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.
After intravenous administration of 1.2 mg of theophylline at 0.6 mg/kg per hour (serum level, 5.6 µg/mL), both Cheyne–Stokes respiration and oxygen desaturation were markedly attenuated. After infusion of 2.4 mg of theophylline (serum level, 11.6 µg/mL), Cheyne–Stokes respiration resolved completely. No change was seen with placebo. Cheyne–Stokes respiration did not recur during outpatient treatment with oral theophylline.
Theophylline may be a rapid and effective therapy for life-threatening Cheyne–Stokes respiration.
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