Irregular breathing

Introduction Irregular breathing patterns are characteristic of increased intracranial pressure. Common tidal breathing, shallow and fast breathing, sobbing-like breathing. Respiratory slowing is more common in patients with posterior fossa hematoma. Irregular breathing and tidal breathing are common in brain stem injury. Tidal breathing: Also known as Chen-Shi breathing, it is a periodic breathing abnormality with a period of about 0.5 to 2 seconds. Breathing is slowed down and slowed down, then the breathing gradually deepens and accelerates, alternating in cycles. More common in central nervous system diseases, such as encephalitis, meningitis, increased intracranial pressure, barbiturate poisoning.

Cause

Due to the reduced excitability of the respiratory center or severe hypoxia, the normal concentration of CO _{2 in the} blood cannot cause respiratory center excitement through chemoreceptors, causing the breathing to gradually weaken and pause. When apnea occurs, CO _{2 in the} blood accumulates, and after a certain degree of increase, the respiratory center is reflexively stimulated by the chemoreceptors of the carotid body and the aorta, causing respiration. As the breathing progresses, the CO ₂ is expelled, the respiratory center loses its effective excitement, and the breathing slows down again, causing a pause, thereby forming a periodic respiratory abnormality.

an examination

Related inspection

Peak expiratory flow (PEFR) plasma endothelin determination

The breathing of the tidal breathing gradually accelerates and deepens from shallow to slow. After reaching the climax, it gradually becomes shallower and slower. After a few seconds of pause (some 30 to 40 seconds), the breathing of the above state occurs again, and its form is undulating.

the reason:

1 Lower airway obstruction, spasm or stenosis, common in bronchial asthma.

2 The elasticity of the lung tissue is reduced, and the driving force for exhalation is reduced.

Two factors work together and are found in chronic obstructive emphysema.

1. Intermittent breath sounds: also known as gear-like breath sounds. Features: Sound intermittently with short irregular intervals. Local inflammation or bronchoconstriction in the lungs causes air to not enter the alveoli evenly.

2. Rough breath sounds: The reason is that the bronchial adhesion education system collects the mild edema or inflammation caused by the surface is not smooth or narrow, making the gas and liquid into poor, seen in the early stage of bronchitis or pneumonia.

(1) Concept: Bronchoalveolar breath sounds are heard in the normal alveolar breath sound region.

(2) Mechanism and cause of discovery: The small lung consolidation zone is interlaced with normal lung tissue, or the lung zone is covered by normal lung tissue. Found in bronchial pneumonia, pneumococcal lung, pleural effusion above the lung insufficiency area.

Differential diagnosis

Breathing irregularities need to be identified as follows: Intermittent breathing: Also known as Biots breathing. After a regular uniform breathing for a few times, stop for a period of time, and then start breathing evenly, that is, intermittent breathing. This breath is different from tidal breathing. It has the same depth of breathing, rather than undulations. The apnea time is longer than that of tidal breathing, and the number of breaths is also significantly reduced. The mechanism of intermittent breathing is almost the same as that of tidal breathing, but the patient's respiratory center is heavier than the tidal breathing, and the condition is more serious. The patient's prognosis is poor, and it often occurs before the breathing completely stops. The disease that causes intermittent breathing is about the same as that of tidal breathing.

The appearance of such breathing is a manifestation of a decrease in the excitability of the respiratory center and an abnormal regulation of the respiratory rhythm by the respiratory center. When the breathing pauses for a period of time, the deprivation of oxygen and carbon dioxide stimulates the respiratory center, so that the breathing recovers and gradually strengthens; when hypoxia and carbon dioxide retention improve, the respiratory center loses effective excitement, the breathing reappears slowly and becomes shallow, and then the breathing occurs. pause. Mild tidal breathing can be seen in the elderly when sleeping, normal people can also appear in a thin air environment. However, most of these respirations are manifestations of critical illness and poor prognosis.

Breathing slows and irregulars: Respiratory slowing irregularly seen in overdose of sleeping pills, sleeping pills are also known as stable, the main ingredient is Xipan, this product is white or off-white crystalline powder; odorless, slightly bitter taste. Almost insoluble in water, soluble in hydrochloric acid. In the case of acid or alkali and heat and easy to hydrolyze, the oral drug is opened under the action of gastric acid, enters the alkaline intestine and re-cyclizes the original drug. Therefore, the bioavailability of the drug is not affected. Anxiety, compensatory rebound is lighter after stopping the drug, and it is difficult to stop the drug. The aftereffect is lighter. The safety range is large. Abnormal breathing: The human respiratory rate is 16 to 20 times per minute for adults, and the ratio to the number of heart beats is 1:4. The average amount of Honduras breathing in quiet time is 500ml (300~700ml), and the ventilation per minute is about 8~10l. Abnormal breathing refers to the frequency of breathing and the change in rhythm concept. When the patient feels that the air is insufficient, the breathing is laborious, objectively, the patient has strong breathing, the respiratory muscles and the auxiliary respiratory muscles all participate in the respiratory movement, the ventilation increases, the respiratory rate, the depth and the rhythm change, which is called dyspnea. The breathing of the tidal breathing gradually accelerates and deepens from shallow to slow. After reaching the climax, it gradually becomes shallower and slower. After a few seconds of pause (some 30 to 40 seconds), the breathing of the above state occurs again, and its form is undulating.

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