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Kussmaul respiration is a labored and deep type of breathing seen in patients with extreme metabolic acidosis, often caused by diabetic ketoacidosis. It is a serious clinical sign that requires immediate medical attention. The body compensates for acidosis by respiratory compensation, and Kussmaul respiration is a form of hyperventilation. It is important to stabilize the patient’s pH level and identify the cause of acidosis for appropriate treatment. Early warning signs should be heeded to prevent life-threatening complications.
Kussmaul respiration is an abnormal type of breathing, characterized by being labored and very deep, that can be seen in patients with extreme metabolic acidosis. This condition is usually identified and treated before Kussmaul respiration develops. Most commonly, this condition is seen in people with diabetic ketoacidosis leading to coma. It is a serious clinical sign and an indicator that immediate medical attention is needed if it has not already been offered.
When patients enter metabolic acidosis, their blood becomes very acidic. The body uses a variety of measures to compensate, including respiratory compensation. Patients in the early stages can breathe rapidly and shallowly. As acidosis progresses, Kussmaul respiration may develop. In Kussmaul respiration, patients breathe at a normal or slightly slower rate, but their breaths are much deeper than usual. This is a form of hyperventilation, which causes carbon dioxide levels in the blood to decrease as oxygen increases.
The patient’s breathing is also very labored. The patient may sigh and can be seen obviously struggling to breathe. Kussmaul’s breathing is involuntary, prompted by an intense hunger for air as the body attempts to compensate for the acidosis. The patient may lose consciousness as Kussmaul respiration develops because the body goes into a state of crisis in response to the drop in blood pH.
This type of breathing takes its name from the German physician who first observed it in 1870 while studying diabetic patients. In patients who have entered metabolic acidosis, it is vital to raise the pH level of the blood to stabilize the patient and then determine what has caused the acidosis so it can be treated. If patients are having difficulty breathing, it is important to ensure that the airway remains clear and to monitor the patient for signs of further complications.
The early stages of metabolic acidosis are sometimes difficult to identify unless a doctor takes care of it. People may feel unwell and may breathe shallowly and rapidly, but the connection to the drop in blood pH may not be immediately established. In a hospital setting, blood gas tests and other laboratory work can show a disruption in blood chemistry, allowing healthcare professionals to intervene with appropriate treatments. People at risk for metabolic acidosis, such as patients with poorly controlled diabetes, should heed early warning signs so they can receive prompt medical attention before life-threatening complications such as coma develop.
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