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