Kussmaul breathing: Pathophysiology, Causes and Treatment

Definition: it is a very dangerous symptom that accompanies the conditions associated with the alteration of the organs and the “acidification of the organism”.

Kussmaul’s breathing is described as slightly faster breathing with extenuating deep breaths. It is a reflexive reaction of the organism and is usually present in unconscious patients.

Kussmaul’s breathing is the name given to a condition in which the patient develops an extremely deep and laborious breathing pattern.

This is mainly observed in people who are diabetic and have severe forms of metabolic acidosis, especially diabetic ketoacidosis with renal dysfunction.

Kussmaul’s breathing can also be explained as a form of hyperventilation .

That is, it is a condition in which an individual inhales in a pattern so deep that the level of carbon dioxide decreases in the blood, which is seen especially in metabolic acidosis where breathing becomes extremely rapid and shallow and as the condition worsens the breathing becomes shallow and deep.

It seems as if the individual is practically panting to breathe.

This type of breathing pattern was first described by Adolph Kussmaul, a German physician in 1874.

He realized that his patients with diabetic ketoacidosis had a breathing pattern that was first labeled as having “air hunger.”

In Kussmaul’s type of breathing, the patient breathes a lot, that is, it is a hyperventilation along with tachypnea. So we’re going to find that the amplitude of the breaths along with the rate will increase. There are usually no pauses between breaths.

This is not specific for diabetic ketoacidosis. It can also appear in other types of severe metabolic acidosis, for example, alcoholic ketoacidosis.

What can Kussmaul Breathing cause?

Kussmaul breathing is a condition that results due to low levels of carbon dioxide in the blood.

It is usually seen in people who have uncontrolled diabetes at the level where they develop diabetic ketoacidosis, resulting in the patient having a very shallow and deep breathing.

The level of carbon dioxide decreases due to the individual’s desire to take a deep breath and exhale more carbon dioxide than the norm resulting in a marked decrease in the level of carbon dioxide in the blood causing hyperventilation or respiration of Kussmaul

The conditions that can cause Kussmaul’s breathing are:

  • Diabetic cetoacidosis:

Diabetic ketoacidosis is a condition in which glucose present in the blood can not be used by the body to produce energy due to the severe need for insulin that is not present.

This results in the body’s inability to get rid of glucose to produce energy for the body.

  • Metabolic acidosis:

This is a medical condition in which there is a substantial increase in lactic acid levels in the bloodstream.

This accumulation of lactic acid in the bloodstream results in kidney dysfunction that becomes difficult for the kidneys to maintain a balance between acid and bases in the body or what can be termed as a balanced pH in the body.

Since the kidneys are not able to filter the excess lactic acid in the body. This finally results in Kussmaul’s breathing.

  • Pneumonia:

This is also one of the causes of Kussmaul’s breathing. Pneumonia is predominantly an infection of the lungs. In this condition the alveoli become filled with fluid and hinder the individual’s normal breathing pattern and end up having Kussmaul’s breathing.

  • Renal insufficiency:

As indicated above if there is a renal dysfunction, the excess accumulation of acid in the body is not able to be filtered out of the body, resulting in an imbalance in the pH in the body causing complications such as Kussmaul breathing.

Before the onset of Kussmaul’s breathing, the patient will have other symptoms that point towards a renal failure such as decreased urination, swelling of the lower extremities, nausea and vomiting.

Peritonitis: This is also one of the medical conditions that can cause Kussmaul’s breathing. This is a medical condition in which the peritoneum becomes inflamed or swollen. This may be due to a malfunction of the liver. When this condition worsens it leads to complications that include Kussmaul’s breathing.


The treatment for Kussmaul breathing depends on the underlying condition that in most cases is uncontrolled diabetes or kidney failure.

The underlying cause of uncontrolled diabetes or kidney failure needs to be treated first that it can automatically treat Kussmaul’s breathing.

In cases of metabolic acidosis as a cause of Kussmaul’s breathing, the treatment focuses on balancing the pH scales in the body to stabilize the individual after which the underlying cause must be addressed.

To treat Kussmaul’s breathing, it is extremely vital to make sure that the patient’s airway remains clear and there are no obstructions.

It may be difficult to identify immediately if the patient is entering the Kussmaul breathing pattern.

There may be breathing problems experienced by patients, but unless a doctor is alert enough to be watching the development of Kussmaul’s breathing, then it can be difficult to diagnose.

If there is a risk that a patient has abnormal pH levels, it is important to put the patient in a hospital setting so that the levels and chemistry of the blood can be monitored and the patient can receive the appropriate treatment to prevent him from developing the respiration of the patient. Kussmaul

Kussmaul’s breathing is not a disease, it’s just a symptom.

Due to the current disruption of the internal environment of the body and habitual unconsciousness, Kussmaul’s breathing must be considered as serious. The therapy consists of treating the underlying cause.