Gasping

Classification according to ICD-10
R06.0	Dyspnea
ICD-10 online (WHO version 2019)

In medicine, gasping for breathing refers to a severe, life-threatening breathing disorder in the deeply unconscious , which often precedes respiratory failure . The gasping breathing is characterized by single snapping breaths with long pauses between them. In lay resuscitation, gasping is often not recognized as a threatening condition.

Signs of gasping

The term gasping is initially used only from the observation of the breathing pattern. Breaths that are relatively easy to recognize are typical for a gasp, since the auxiliary breathing muscles are used and the mouth is opened to take a breath. At the same time, the person concerned has turned pale or blue ( cyanotic ). The breathing rate is reduced and is usually below 10 / min. Often there is already clouding due to the falling oxygen level in the blood . The tongue often falls back and the tidal volume is too small.

Breathing is erratic, breathing in through the mouth bends the head back, exhaling through the nose and mouth, and the head sinks forward again. The gasp is accompanied by an upward and downward path of the larynx with the mouth open.

Causes of gasping

All causes of respiratory arrest can also be the cause of gasping.

Overdose of sleeping pills or opiates
Severe lung disease
Severe heart failure
Heavily pushed up diaphragms due to masses in the abdomen

The gasp breathing also occurs shortly before death and stands for the last breaths of the dying ( agonal breathing ).

Pathophysiology

The gasping breath is probably based on diaphragmatic contractions , which occur when the oxygen partial pressure in the blood falls below about 20 mm Hg. The pathophysiological mechanism of this type of breathing is based on the relatively greater hypoxia tolerance of the inspiratory neurons compared to the neurons of the brain stem responsible for expiration .

treatment

The gasping breath requires immediate treatment.

Clear the airway
Immediate resuscitation (laypersons: BLS-AED scheme, according to ERC 2010, since "breathing is not normal")
Bag-mask ventilation
if possible: give oxygen
if possible: secure the airways . With experienced staff z. B. by immediate endotracheal intubation
Flumazenil as an antidote to benzodiazepine preparations (to rule out a sleeping pill overdose)
Naloxone as an antidote to opiates
Breath aleptics such as theophylline

Trivia

In the political debate since the mid-2010s, the term gasping has occasionally been used by the New Right in Germany to describe the indignant or supposedly exaggerated or hysterical reaction of the political opponent or so-called do - gooders .

literature

Pschyrembel . Clinical Dictionary. 262nd revised edition 2010. ISBN 978-3-11-021152-8 .

Web links

Wiktionary: Schnappatmung - explanations of meanings, word origins, synonyms, translations

Individual evidence

^ H. Benzer: Therapy of respiratory failure. In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid 1994, ISBN 3-540-57904-4 , pp. 215-278; here: p. 218.

[1] H. Benzer: Therapy of respiratory failure. In: J. Kilian, H. Benzer, FW Ahnefeld (ed.): Basic principles of ventilation. Springer, Berlin a. a. 1991, ISBN 3-540-53078-9 , 2nd, unchanged edition, ibid 1994, ISBN 3-540-57904-4 , pp. 215-278; here: p. 218.