ECG derived Cheyne-Stokes respiration and periodic breathing are associated with cardiorespiratory arrest in intensive care unit patients

Abstract

Background: Cheyne-Stokes respiration and periodic breathing (CSRPB) have not been studied sufficiently in the intensive care unit setting (ICU).

Objectives: To determine whether CSRPB is associated with adverse outcomes in ICU patients.

Methods: The ICU group was divided into quartiles by CSRPB (86 patients in quartile 1 had the least CSRPB and 85 patients in quartile 4 had the most CSRPB). Adverse outcomes (emergent intubation, cardiorespiratory arrest, inpatient mortality and the composite of all) were compared between patients with most CSRPB (quartile 4) and those with least CSRPB (quartile 1).

Results: ICU patients in quartile 4 had a higher proportion of cardiorespiratory arrests (5% versus 0%, (p=.042), and more adverse events over all (19% versus 8%, p=.041) as compared to patients in quartile 1.

Conclusions: CSRPB can be measured in the ICU and it's severity is associated with adverse outcomes in critically ill patients.

Keywords: Cardiopulmonary arrest; Central sleep apnea; Cheyne–Stokes respiration; Intensive care units; Intubation; Mortality, Intubation.