Kussmaul respiration is an abnormal pattern of respiration characterized by deep and hurried breathing. It is one of the most distinctive feature of diabetic ketoacidosis, a serious metabolic complication of diabetes with associated dysfunction of kidneys.
Kussmaul breathing causes low level of carbon dioxide in the blood. When the acid content in the blood increases as in metabolic acidosis, diabetic acidosis, or kidney failure, there is increased desire by the patient to breathe deep and rapidly. As a result carbon dioxide saturation in blood decreases.
In the beginning, it is shallow and rapid respiration, however, as the condition worsens, it leads to rapid and fast breathing.
What Causes Kussmaul Respirations?
Kussmaul breathing is a condition which results from low level of carbon dioxide in blood. This abnormal form of respiration is commonly seen in people having diabetic ketoacidosis. Kussmaul respiration is deep and fast breathing. Deep breathing and rapid exhalation causes low level of carbon dioxide in the blood leading to hyperventilation. Following conditions can cause kussmaul respiration.
- Diabetic ketoacidosis: This condition occurs in people suffering from type 1 and type 2 diabetes.It occurs when there is absolute insulin deficiency as in type 1 diabetes or among people with uncontrolled diabetes as in type 2 diabetes. Deficiency of insulin hormone hampers utilization of glucose as an energy source for cellular activity of the muscles and tissues. Body has to rely on fat and protein for energy source instead of glucose, although there is increased circulating glucose in the blood. Breakdown of fat and protein causes release of waste products in the form of ketones. Rise of ketone makes the blood acidic leading to hyperventilation or kussmaul breathing.
- Metabolic acidosis: The condition is characterized by increase of lactic acid in blood. Buildup of lactic acid is seen more in patients suffering from chronic renal failure, carbon monoxide poisoning, diabetes, liver disease, after intense exercise, alcoholism etc. Too much of lactic acid buildup due to lack of excretion from kidney gives rise to kussmaul respiration.
- Pneumonia: It is an infection of lung where the tiny alveoli get filled with fluid and pus. Exchange of gasses usually takes place within the walls of alveoli of lungs. Swollen air sacs prevent proper air exchange and result in strenuous respiration in the form of deep and rapid breathing.
- Chronic and acute kidney failure: With dysfunction of kidney, there is accumulation of toxic waste in the body. This leads to kussmaul breathing.
- Peritonitis: Peritoneum is a layer in the abdomen which keeps the organs in their place. Infection and inflammation of peritoneum can be life threatening. Kussmaul respiration is one of its sign and symptom.
Treatment For Kussmaul Respirations
Kussmaul respiration is one of the sign of an underlying condition, which in most of the cases is diabetic ketoacidosis leading towards coma or renal failure. The respiration is involuntary and it automatically becomes normal once the underlying condition is treated.
In case of metabolic acidosis, it is very difficult to perceive the condition in early stage. The person may have shallow and rapid breathing, but its association with rapid changes in blood pH might go unnoticed. However, when the patient is in hospital, blood gas estimation test and other relevant test will help in early diagnosis which allows the doctor to start appropriate treatment and prevent kussmaul respiration.