Agonal breathing is a near-death condition where a person gasps and moans. Their face may grimace as if they're in pain. But, like with agonal rhythm, a person experiencing agonal breathing isn't in agony. Most likely, they're unconscious and what you see is only a reflex.
Depending on the cause of agonal breathing, the person may or may not be conscious. This agonal respiration most often happens after the heart has stopped. So there is no blood being pumped to the brain, or anywhere else.
Agonal Breathing Definition
Agonal breathing or agonal respirations are medical terms used to describe insufficient breathing that often sounds like snoring, snorting, gasping, or labored breathing. The person will appear to be choking or having an involuntary gasp reflex.
Agonal breathing is the medical term for gasping for breath. It is usually a symptom of a severe medical emergency, such as stroke or cardiac arrest. Agonal breathing can be brief or it may last for several hours. The gasping associated with agonal breathing is not true breathing, but rather a brainstem reflex.
You can respond to cases of agonal breaths by providing CPR chest compressions and using an AED. Other medical intervention include administering drugs to treat the underlying cause and provide ventilation or intubation if oxygen isn't entering the body properly.
The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours.
As the moment of death comes nearer, the person's breathing may slow down and become irregular. It might stop and then start again or there might be long pauses or stops between breaths. This is sometimes known as Cheyne-Stokes breathing.
Agonal Rhythm - Ventricular Rhythms
Heart rate is less than 20 bpm, without P waves and a wide, bizarre QRS complex. The rate is often so slow, that on a singular six-second rhythm strip it will be impossible to determine whether the rhythm is regular or irregular.
These periods of apnea will eventually increase from a few seconds to more extended periods during which no breath is taken. This pattern or respirations is known as Cheyne-Stokes breathing, named for the person who first described it, and usually indicates that death is very close (minutes to hours).
Agonal breathing is slow, very shallow irregular respirations. Kussmaul's respiration is a deep, sighing respiration with normal or slow rate. Sighing respiration is a normal physiologic reaction of human body to fatigue and emotional changes.
These end-of-life breathing patterns can happen very quickly, or it can occur over many hours or even days. This is a normal part of the dying process as the body begins to slowly shut down.
In an unresponsive, pulseless patient in cardiac arrest, agonal gasps are not effective breaths. Agonal respiration occurs in 40% of cardiac arrests experienced outside a hospital environment.
An unresponsive and breathing person has normal, regular breathing, but does not respond to any sound or touch from another person. A person may become unresponsive due to an injury (e.g., hitting their head) or a medical condition (e.g., diabetic emergency) that may indicate a greater danger to their health.
Cheyne-Stokes breathing may be agonizing to watch, but it is not uncomfortable for the dying person. It is simply the body's way of compensating for physiological changes as the lungs, heart, kidney, liver, and brain start to fail in succession.
Irregular breathing, panting and periods of not breathing may occur. Changes in breathing are very common and indicate a decrease in circulation to the internal organs. While these changes are not usually bothersome to the patient, they can be distressing to family members. Elevating the head may provide relief.
The first organ system to “close down” is the digestive system. Digestion is a lot of work! In the last few weeks, there is really no need to process food to build new cells. That energy needs to go elsewhere.
Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours.
Agonal respiration is an abnormal pattern of breathing and brainstem reflex characterized by gasping and gulping breaths that are accompanied by strange vocalizations.
Clinically, an agonal rhythm is regarded as asystole and should be treated equivalently, with cardiopulmonary resuscitation and administration of intravenous adrenaline. As in asystole, the prognosis for a patient presenting with this rhythm is very poor.
Humans have an instinctive desire to go on living. We experience this as desires for food, activity, learning, etc. We feel attachments to loved ones, such as family members and friends, and even to pets, and we do not want to leave them.
The term agony, deriving from the Greek ἀγωνία that means “fight”, defines the last moments of the living organism's existence before the encounter with death, and its phenomenology is still to be explored. One of the most problematic issues related to agony is its length.
They Know They're Dying
Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming.