From the Guidelines
Kussmaul breathing, also known as hyperpnea, is a respiratory pattern characterized by deep and labored breathing, typically seen in patients with metabolic acidosis, and is the body's compensatory mechanism to eliminate excess acid through the lungs by increasing carbon dioxide exhalation. This breathing pattern is often accompanied by other symptoms such as fruity breath odor, excessive thirst, frequent urination, nausea, and abdominal pain, particularly in diabetic ketoacidosis (DKA) 1. Key features of Kussmaul breathing include:
- Deep, labored breaths
- Increased respiratory rate (>20 breaths per minute)
- Regular rhythm
- Often accompanied by a fruity breath odor (acetone) in DKA The perception of breathing effort or work can be produced by various factors, including external resistive or elastic loads, volitional hyperpnea, or weakening of the respiratory muscles via changes in operating length, fatigue, or partial neuromuscular blockade 1. It is essential to assess for other signs of DKA and check blood glucose levels if Kussmaul breathing is observed, and seek emergency medical care immediately. Treatment focuses on addressing the underlying cause, such as IV fluids, insulin therapy, and electrolyte management for DKA, or treating the specific condition for other causes of metabolic acidosis. Understanding Kussmaul breathing is crucial for early recognition and prompt treatment of potentially life-threatening metabolic disturbances.
From the Research
Definition and Characteristics
- Kussmaul breathing, also known as hyperpnea, is a respiratory pattern characterized by deep and labored breathing 2, 3.
- It is often associated with diabetic ketoacidosis (DKA) and can be triggered by repeated vomiting or other conditions that lead to a sudden increase in intra-alveolar pressure 4, 5.
Clinical Significance
- Kussmaul breathing is a significant clinical sign that can indicate the presence of DKA or other serious conditions, such as Hamman's syndrome 4, 5.
- It is essential to recognize Kussmaul breathing as a potential complication of DKA, especially in pediatric patients, to ensure prompt diagnosis and management 5.
Historical Context
- The term "Kussmaul breathing" is named after Adolf Kussmaul, a German physician who first described the condition in the 19th century 2, 3.
- Kussmaul was a pioneer in the field of medicine, making significant contributions to the diagnosis and treatment of various diseases, including those related to the respiratory system 2, 3.
Related Conditions
- Kussmaul breathing can be associated with other conditions, such as hyperosmolar hyperglycemic state (HHS), which is a serious acute hyperglycemic emergency in patients with type 2 diabetes 6.
- HHS is characterized by severe hyperglycemia and glycosuria, often without Kussmaul breathing, and has a higher mortality rate compared to DKA 6.