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1 Departments of Pulmonary Medicine, 2 Thoracic Surgery, and 3 Anesthesia and Critical Care Medicine, University Hospital, S-901 85 Umeå, Sweden
Received 21 October 1996; accepted in final form 23 May 1997.
Franklin, Karl A., Erik Sandström, Göran
Johansson, and Eva M. Bålfors. Hemodynamics, cerebral
circulation, and oxygen saturation in Cheyne-Stokes respiration.
J. Appl. Physiol. 83(4): 1184-1191, 1997.
Because cardiovascular disorders and stroke may induce
Cheyne-Stokes respiration, our purpose was to study the interaction
among cerebral activity, cerebral circulation, blood pressure, and
blood gases during Cheyne-Stokes respiration. Ten patients with heart
failure or a previous stroke were investigated during Cheyne-Stokes
respiration with recordings of daytime polysomnography, cerebral blood
flow velocity, intra-arterial blood pressure, and intra-arterial oxygen
saturation with and without oxygen administration. There were
simultaneous changes in wakefulness, cerebral blood flow velocity, and
respiration with accompanying changes in blood pressure and heart rate
~10 s later. Cerebral blood flow velocity, blood pressure, and heart
rate had a minimum occurrence in apnea and a maximum occurrence during
hyperpnea. The apnea-induced oxygen desaturations were diminished
during oxygen administration, but the hemodynamic alterations
persisted. Oxygen desaturations were more severe and occurred earlier
according to intra-arterial measurements than with finger oximetry. It
is not possible to explain Cheyne-Stokes respiration by alterations in
blood gases and circulatory time alone. Cheyne-Stokes respiration may
be characterized as a state of phase-linked cyclic changes in cerebral,
respiratory, and cardiovascular functions probably generated by
variations in central nervous activity.
ultrasonography; Doppler; transcranial; blood pressure; transcutaneous blood-gas monitoring; cerebrovascular circulation
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