Pulmonary Compliance in Patients with Periodic Breathing

A study of pulmonary compliance in patients with periodic breathing was made. The elastic properties of the lung were found to be normal in some patients and grossly decreased in others. Two types of periodic breathing mechanics were found: in one there are similar variations of tidal volumes and unchanged pulmonary compliance; in the other a constant fluctuation of the intraesophageal pressure associated with the variations in tidal volume. CHEYNE, a professor in Dublin, reported a description of the breathing of one of his patients. "For several days his breath-ilng was irregular; it would entirely cease for a quarter of a minute, then it would become perceptible, though very low, then by degrees it became heaving and quick a minute during which there were thirty acts of respiration." This was the first clinical description of peri-odic breathing. ' Thirty-six years later Stokes2 described similar breathing in a pa-tient of his own. "For more than two months before his death, this singular character of respiration was always present, and so long would the periods of suspension be, that his attendants were frequently in doubt whether he was not actually dead. Then a very feeble, indeed barely perceptible inspiration would take place, followed by another somewhat stronger, until at length high heaving, and even violent breathing was established, which would then subside till the next suspension. This was frequently a quarter of a minute in duration... " Twenty-four years later Traube advanced the first noteworthy theory of the mechanism of Cheyne-Stokes breath-ing.3 He described 2 types of Cheyne-Stokes breathing, namely that with an intracranial lesion in the presence of an intact heart, and that with cardiac disease but no change in the brain. He believed that a diminished arterial blood supply to the brain was th