Agonal respiration

Gasping is a term used in medicine. He refers to a severe life- threatening respiratory disorder that often precedes respiratory arrest. The gasping is characterized by individual snatching breaths between which there are long pauses. In the Laienreanimation the gasping is often not recognized as threatening condition.

Signs of gasping

The term gasping is first used only by the observation of the breathing pattern here. Typical of gasping breaths are relatively easily recognizable because the respiratory muscles is used and with the mouth is opened for better breathing. At the same time the person is pale or blue (cyanotic ) has been launched. The respiratory rate is reduced and is usually less than 10/min. There is often because of the falling oxygen levels in the blood already clouding ago. The tongue often falls back and the tidal volume is small.

Breathing is shock- way, by inhalation through the mouth, the head is bent backward, is exhaled through the nose and mouth and the head falls forward again.

Causes of Gasping

All causes of apnea may be the cause even when the gasping.

  • Overdose of sleeping pills or opiates
  • Severe pulmonary disease
  • Severe heart failure
  • Highly highly compressed diaphragms by a stomach problem

The gasping also occurs shortly before death and is the last breaths of a dying man ( agonal breathing).

Pathophysiology

Probably due to the gasping diaphragmatic contractions that occur in a pronounced decrease of the oxygen concentration in the blood of less than about 20 mm Hg. Merits of the pathophysiological mechanism of this type is the breath compared to the charge of the expiration neurons of the brainstem, relatively greater hypoxia tolerance of inspiratory neurons.

Treatment

The gasping need of immediate treatment.

  • Free the airway
  • Immediate resuscitation (lay: BLS- AED scheme, according to ERC 2010, as " breathing not normal")
  • If no resuscitation is performed: Stable side storage
  • Bag-mask ventilation
  • If possible: oxygen administration
  • If possible: securing the airway. With experienced staff, for example, by immediate endotracheal intubation
  • Flumazenil as an antidote to Benzodiazepinpräparate ( to the exclusion of a sleeping pill overdose )
  • Naloxone as an antidote to opiates
  • Atemanaleptika such as theophylline
Recovery position Mechanical ventilation
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