Background: Cheyne-Stokes respiration is characterized by periodic breathin
g that alternates with hypopnea or apnea.
Objective: To describe the effect of theophylline on near-fatal Cheyne-Stok
es respiration.
Design: Case report.
Setting: Tertiary referral center.
Patient: A 48-year-old diabetic woman with a history of three cardiorespira
tory arrests, a normal coronary arteriogram, normal left ventricular functi
on, and severe Cheyne-Stokes respiration.
Measurements: Oxygen saturation, intra-arterial blood pressure, central Ven
ous pressure, chest wall movement, electrocardiography, electromyography, e
lectroencephalography, electro-oculography, minute ventilation, arterial bl
ood 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 mu g/mL), both Cheyne-Stokes respiration a
nd oxygen desaturation were markedly attenuated. After infusion of 2.4 mg o
f theophylline (serum level, 11.6 mu g/mL), Cheyne-Stokes respiration resol
ved 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-thre
atening Cheyne-Stokes respiration.