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What Is Agonal Respiration?

Agonal respiration refers to the irregular breathing pattern that usually occurs prior to a terminally ill patient's death.
CPR should be administered immediately to cardiac arrest patients who are experiencing agonal respiration.
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  • Written By: Jennifer Mackin
  • Edited By: Michelle Arevalo
  • Last Modified Date: 31 October 2014
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Agonal respiration is a medical term used to describe a person who is no longer breathing in a normal pattern, but instead breathing in short, sporadic gasps of air. This abnormal breathing pattern usually occurs right before death in patients suffering from terminal illnesses or cardiac arrest, and should not be confused with a person who is hyper-ventilating or winded. The sound can be described as gasping, gurgling, and moaning, and is also related to Cheyne-Stokes respiration and the death rattle.

A healthy person usually breathes in a regular pattern and takes up to 15 to 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, like when a person is exercising. With agonal respiration, 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 though the person is taking in air, he or she is not considered to be actively breathing. This is a medical emergency and, if not treated immediately, can lead to death.

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The length of time that a person exhibits agonal respiration depends on a few things. Some people may only take one or two gasps before dying, while others can continue the abnormal breathing pattern for a few minutes. People suffering from terminal lung cancer or emphysema can gasp for air for hours before death occurs. Medical personnel can intervene and get the body working properly again, however, if the person has signed a do-not-resuscitate order, these breathing patterns will eventually result in death.

In cardiac arrest patients, agonal respiration can sometimes be a good sign. After a heart attack, the heart will usually stop beating, causing the rest of the organs to stop functioning. People who exhibit agonal respiration after cardiac arrest can actually have a better prognosis than people who do not, because the brain is still functioning and fighting to get oxygen into the body. Cardiac pulmonary resuscitation (CPR) should be administered immediately in such cases, to try and kick start the heart into beating again.

Though agonal breathing is closely related to Cheyne-Stokes respiration and the death rattle, the terms are typically used for specific breathing patterns before death. Agonal respiration is usually used in connection with cardiac arrest patients, while Cheyne-Stokes respiration is used to describe a person who is near death and whose breathing patterns fluctuate from being very fast to really slow. A separate term, the death rattle is usually used to describe the very last breath a person inhales and exhales before he or she dies.

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anon976245
Post 4

Our American Red Cross rescuers are still giving breaths. I'm also an instructor.

anon976244
Post 3

Actually, the death rattle is the mucus in the airway. It sounds like congestion/drowning.

Jewellian
Post 2

In the case of cardiac arrest, most people may not realize that the rules have changed for CPR. It used to be that chest compressions were administered along with breathing into the heart attack victim's mouth. No longer. The new CPR rules call for rapid chest compressions only. Check with your local chapter of the American Red Cross for more info.

Ahmerus
Post 1

"Death rattle"; the term just sounds so macabre. But, I guess it is easier to remember than the scientific name; "agonal" breathing or "Cheyne-Stokes" respiration. I hope I will never have to use either terms, but just in case I will try to remember the scientific rendering, so as to avoid using the term "death rattle".

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