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 often occurs in patients suffering from terminal illnesses or cardiac arrest and may be a sign that death is near. There are other possible causes however and this should not be confused with a person who is hyper-ventilating, winded or breathing abnormally due to a non-terminal respiratory disorder. The sound may 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.
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. Agonal respiration is usually used in connection with 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 lack of breathing, may also be present. A separate term, the death rattle is usually used to describe the rattle like noises a patient makes while breathing due to saliva or fluid buildup in the throat and/or airways. It has been named as “death” rattle since it often occurs in the last days and hours of terminally ill patients due to difficulty swallowing. Cheyne-Stokes respiration is also common in the last days of patients’ lives.