Biot's Breathing Pattern illustration

Biot’s Breathing Pattern: An Overview (2024)

by | Updated: Mar 20, 2024

Biot’s breathing, named after the 19th-century French physician Camille Biot, is a form of abnormal respiratory pattern that can provide crucial insights into an individual’s neurological condition.

This specific pattern of breathing is characterized by a sequence of regular, deep breaths (identical in depth and duration), followed by a period of apnea, a complete cessation of breathing for several seconds.

This article provides an overview of Biot’s breathing pattern, including its causes and clinical implications.

What is Biot’s Breathing?

Biot’s breathing is a chaotic respiratory pattern characterized by irregular periods of deep, shallow, fast, and slow breathing. This pattern eventually turns into agonal breathing, which leads to apnea.

Biot’s breathing is common in patients with acute neurological disease that results from damage to the medulla or pons in the brain. This can occur due to a stroke, trauma, or severe intracranial hypertension.

Biot's Breathing Pattern Illustration Vector Graphic

Description of Biot’s Breathing Pattern

In Biot’s breathing, the individual exhibits an irregular sequence of breaths, which can vary in depth and rate, followed by a sudden, temporary suspension of breaths.

This is different from normal, consistent breathing, where the rate and depth of breaths are generally steady and rhythmical.

The unique aspect of Biot’s breathing is the unpredictability of its pattern. The periods of apnea can be of varying lengths, with no evident consistency in the length of these pauses.

The depth and rate of the breaths before and after these apneas can also vary significantly, adding to the irregularity of this breathing pattern.

Clinical Significance of Biot’s Breathing Pattern

Biot’s breathing pattern is not a disease in itself but is usually a sign of a more serious underlying condition. It is often seen in patients with brain damage, particularly those who have experienced severe head trauma, stroke, or brain hemorrhage.

It can also manifest in patients with spinal meningitis, encephalitis, or other conditions affecting the central nervous system. Biot’s breathing is typically observed in individuals in a critical state, often in intensive care units.

Biot’s breathing can help clinicians discern conditions associated with brainstem or high spinal cord injuries. The brainstem, which controls basic life functions such as breathing, is likely to be involved when this pattern emerges.

This unusual breathing pattern might be an early sign of brainstem dysfunction, and immediate medical attention is required to prevent further complications or potentially fatal outcomes.

Who was Camille Biot?

Camille Biot was a French physician who lived during the 19th century. He is best known in the medical field for first identifying and describing Biot’s breathing or Biot’s respiration, a pattern of breathing that is irregular in both rate and depth, and often seen in patients with serious neurological damage.

His work has had a lasting impact on the field of medicine, especially in neurology and respiratory care, given that the breathing pattern he identified continues to bear his name and serves as an essential diagnostic tool.

Biot’s Breathing vs. Cheyne-Stokes Respiration

Biot’s breathing is sometimes confused with another abnormal breathing pattern known as Cheyne-Stokes respiration. Both involve irregular breaths followed by apneas. However, they can be distinguished by the depth and speed of breaths in the two patterns.

Cheyne-Stokes respiration is characterized by a gradual increase and then decrease in the depth and speed of breaths, forming a waxing and waning pattern, followed by a period of apnea.

In contrast, the breaths in Biot’s respiration have a more constant depth and speed and lack the cyclical pattern seen in Cheyne-Stokes respiration.

How is Biot’s Breathing Associated with Acute Bacterial Meningitis?

Biot’s breathing is a rare and abnormal respiration pattern characterized by periods of apnea that alternate irregularly with a series of breaths of equal depth that terminate abruptly.

In the context of acute bacterial meningitis, as seen in the case of the 19-month-old boy, Biot’s breathing appeared several hours after admission to the hospital. This breathing pattern is associated with increased intracranial pressure, a common complication of meningitis.

The presence of Biot’s breathing can be a warning sign of brainstem compression and is considered a foreboding clinical sign associated with central nervous system damage, such as that caused by meningitis.

FAQs About Biot’s Breathing

Is Biot’s Breathing Folklore?

No, Biot’s breathing is not folklore. It is a recognized medical term used to describe a pattern of irregular respiration characterized by varied depth and rate of breaths followed by periods of apnea.

This breathing pattern serves as a significant clinical marker for severe neurological conditions.

What Causes Biot Respirations?

Biot respirations are typically caused by damage to the medulla oblongata or pons in the brainstem, due to conditions such as severe brain injury, stroke, or brain hemorrhage. It can also be seen in conditions like meningitis and encephalitis.

This part of the brain is responsible for regulating vital life functions, including respiration, and damage to it can disrupt normal breathing patterns.

What is Another Name for Biot’s Respiration?

Biot’s respiration is also sometimes referred to as “ataxic respiration.” However, it’s important to note that it’s most commonly referred to as Biot’s breathing or Biot’s respiration in medical literature.

What Does Biot’s Respirations Sound Like?

Biot’s respirations consist of regular or irregular breaths of similar depth, followed by a variable period of apnea (or cessation of breathing).

Therefore, it sounds like a series of breaths taken at equal depth and rate, followed by a sudden, unpredictable pause in breathing. The irregular rhythm and unpredictable pauses can make it quite distinctive.

Was Biot the First to Point Out This Breathing Pattern?

Yes, Camille Biot, a 19th-century French physician, was the first to identify and describe this irregular breathing pattern, which is why it is named after him — Biot’s breathing or Biot’s respiration.

What is Ataxic Breathing?

Ataxic breathing is a type of abnormal breathing pattern characterized by irregularity in the depth and the rhythm of respiration.

This pattern is distinguished by periods of deep, gasping breaths with irregular pauses, varying in length, and usually followed by periods of apnea, or cessation of breathing.

Ataxic breathing is usually indicative of serious neurological conditions or damage, particularly affecting the medulla oblongata, a part of the brainstem that controls vital functions, including heart rate and respiration.

Final Thoughts

Biot’s breathing, while not a disease itself, serves as a critical indicator of severe neurological conditions. Recognizing this pattern can enable swift medical intervention, potentially preventing further health complications.

As such, awareness and understanding of Biot’s respiration is essential, particularly among healthcare professionals who can utilize this knowledge to promptly identify, diagnose, and manage underlying health conditions.

As our understanding of neurological diseases and respiratory patterns advances, these insights will continue to be invaluable in enhancing patient care and outcomes.

John Landry, BS, RRT

Written by:

John Landry, BS, RRT

John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.

References

  • Wijdicks EF. Biot’s breathing. J Neurol Neurosurg Psychiatry.
  • Rudrappa M, Modi P, Bollu PC. Cheyne Stokes Respirations. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing
  • Guri A, Scheier E, Adi M, et alBiot’s breathing associated with acute bacterial meningitis in a childCase Reports 2018;2018

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