Kussmaul breathing: Pathophysiology, Causes and Treatment

Definition: it is a very dangerous symptom that accompanies the conditions associated with altering 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 intense and laborious breathing pattern.

This is mainly observed in people who have diabetes 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.

It is a condition in which an individual inhales in a pattern so deep that carbon dioxide levels decrease in the blood, especially in metabolic acidosis, where breathing becomes extremely rapid and shallow. 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 labeled “air hunger.”

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

This is not specific to 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 with uncontrolled diabetes at the level where they develop diabetic ketoacidosis, resulting in the patient having 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 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 with a substantial increase in lactic acid levels in the bloodstream.

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

Since the kidneys cannot 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 regular breathing pattern and have Kussmaul’s breathing.

  • Renal insufficiency:

As indicated above, if there is renal dysfunction, the excess accumulation of acid in the body cannot be filtered out, 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 of renal failures, 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, including Kussmaul’s breathing.


The treatment for Kussmaul’s breathing depends on the underlying condition, uncontrolled diabetes or kidney failure.

The underlying cause of uncontrolled diabetes or kidney failure needs to be treated first so 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 vital to ensure that the patient’s airway remains clear and there are no obstructions.

It may be difficult to identify immediately if the patient enters 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, it can be challenging to diagnose.

Suppose there is a risk that a patient has abnormal pH levels. In that case, it is essential to put the patient in a hospital setting to monitor the stories and chemistry of the blood. The patient can receive the appropriate treatment to prevent him from developing the patient respiration. Kussmaul

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

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