RSS Feeds
Theophylline Therapy for Near-Fatal Cheyne–Stokes Respiration: A Case Report
- Catherine A. Pesek, DO;
- Ryan Cooley, MD;
- Krzysztof Narkiewicz, MD, PhD;
- Mark Dyken, MD;
- Neal L. Weintraub, MD; and
- Virend K. Somers, MD, PhD
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 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.
Article and Author Information
-
Grant Support: Drs. Pesek and Cooley are supported by a National Institutes of Health (NIH) Interdisciplinary Cardiovascular Research Fellowship HL07121. Dr. Narkiewicz is a recipient of an International Research John E. Fogarty Fellowship from the NIH (3F5 TW05200) and a Perkins Memorial Award from the American Physiological Society. Dr. Weintraub is supported by an NIH Program Project Grant (HL9264-06) and an American Heart Association Clinician Scientist Award (96 004540). The study was also supported by a Sleep Academic Award from the NIH, an Established Investigator Grant from the American Heart Association, and NIH grant HL61560 (Dr. Somers).
-
Requests for Reprints: Virend K. Somers, MD, PhD, Cardiovascular Division and Cardiovascular Center, Department of Internal Medicine, College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242-1081.
-
Current Author Addresses: Drs. Pesek, Weintraub, and Somers: Cardiovascular Division and Cardiovascular Center, Department of Internal Medicine, College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242-1081.
-
Dr. Cooley: Sinai Samaritan Medical Center, 945 North 12th Street, Milwaukee, WI 53233-1306
-
Dr. Narkiewicz: Department of Hypertension and Diabetology, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland.
-
Dr. Dyken: Sleep Disorder Center, Department of Neurology, College of Medicine, 200 Hawkins Drive, University of Iowa, Iowa City, IA 52242-1081.
- Copyright ©2004 by the American College of Physicians
