Agonal respiration is irregular, gasping breaths that can occur in patients with terminal illness or cardiac arrest. It is not the same as hyperventilation or non-terminal respiratory disorders. It is a medical emergency and can lead to death if not treated immediately. In some cases, it can be a good sign after cardiac arrest. It is related to Cheyne-Stokes breathing and death rattle, but each term describes specific breathing patterns.
Agonal respiration is a medical term used to describe a person who no longer breathes normally, but instead breathes in short, sporadic gasps of air. This abnormal breathing pattern often occurs in patients suffering from terminal illness or cardiac arrest and can be a sign that death is near. There are other possible causes, however, and this should not be confused with a person who is hyperventilating, out of breath, or breathing abnormally due to a non-terminal respiratory disorder. The sound can be described as gasping, gurgling and moaning, and is also related to Cheyne-Stokes breathing and death rattle.
A healthy person usually breathes evenly and takes up to 15-20 breaths per minute when the body is at rest. The human body is designed to increase the amount of breaths taken when the body needs more oxygen, such as when a person is exercising. With agonal breathing, a person may only take three or four irregular breaths per minute. The infrequent gasps do not give the body the oxygen it needs to survive, so even if the person is breathing in, they are not considered to be actively breathing. This is a medical emergency and, if not treated immediately, can lead to death.
The length of time a person exhibits agonal respiration depends on a few things. Some people may take just one or two gasps before dying, while others may continue the abnormal breathing pattern for a few minutes. People suffering from terminal lung cancer or emphysema can be out of breath for hours before death occurs. Medical personnel can step in and get the body back to working properly, however, if the person has signed a no-resuscitation order, these breathing patterns will eventually result in death.
In patients with cardiac arrest, agonal breathing can sometimes be a good sign. After a heart attack, the heart usually stops beating, causing the rest of the organs to stop working. People who exhibit agonal breathing after cardiac arrest may actually have a better prognosis than people who don’t, because the brain is still functioning and struggling to get oxygen into the body. Cardiac pulmonary resuscitation (CPR) should be given immediately in these cases, to try to get the heart beating again.
Although agonal breathing is closely related to Cheyne-Stokes respiration and death rattle, the terms are typically used for specific breathing patterns. Agonal respiration is usually used in relation to cardiac arrest patients, while Cheyne-Stokes respiration is used to describe a person whose breathing patterns fluctuate between shallow, deep, and rapid. Apnea or momentary shortness of breath may also be present. A separate term, death rattle is usually used to describe rattles as the noises a patient makes while breathing due to saliva or fluid buildup in the throat and/or airways. It has been called the “death” rattle as it often occurs in the last days and hours of the terminally ill due to difficulty swallowing. Cheyne-Stokes respiration is also common in the last days of life of patients.
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