• C A Pesek, R Cooley, K Narkiewicz, M Dyken, N L Weintraub, and V K Somers.
• University of Iowa, Iowa City 52242-1081, USA.
• Ann. Intern. Med. 1999 Mar 2; 130 (5): 427-30.

BackgroundCheyne-Stokes respiration is characterized by periodic breathing that alternates with hypopnea or apnea.ObjectiveTo describe the effect of theophylline on near-fatal Cheyne-Stokes respiration.DesignCase report.SettingTertiary referral center.PatientA 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.MeasurementsOxygen 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.ResultsAfter intravenous administration of 1.2 mg of theophylline at 0.6 mg/kg per hour (serum level, 5.6 microg/mL), both Cheyne-Stokes respiration and oxygen desaturation were markedly attenuated. After infusion of 2.4 mg of theophylline (serum level, 11.6 microg/mL), Cheyne-Stokes respiration resolved completely. No change was seen with placebo. Cheyne-Stokes respiration did not recur during outpatient treatment with oral theophylline.ConclusionTheophylline may be a rapid and effective therapy for life-threatening Cheyne-Stokes respiration.

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