Kussmaul Breathing

Kussmaul breathing is fast, deep and labored breathing that’s a sign of life-threatening health conditions. It’s a type of hyperventilation. It can happen when your blood becomes too acidic (metabolic acidosis). Your body makes you breathe this way automatically to try to compensate — it’s not something you can control.

You might also have:

• Extreme thirst
• Frequent peeing
• Nausea and vomiting
• Abdominal pain
• Fruity-smelling breath
• Tiredness or weakness
• Confusion

Kussmaul breathing is a sign of a medical emergency. Call 911 or go to the ER if you or someone you’re with is taking deep, rapid breaths or appears to be struggling to breathe.

Kussmaul breathing is most often a sign of diabetes-related ketoacidosis (DKA), a potentially life-threatening complication of diabetes. DKA can happen if you have Type 1 diabetes and don’t know it. It can also happen if you have a diabetes diagnosis and don’t get enough injected insulin.

What is the difference between Kussmaul breathing and Cheyne-Stokes respirations?

Kussmaul breathing and Cheyne-Stokes respirations are both abnormal breathing patterns. Cheyne-Stokes breathing involves periods of fast, shallow breathing followed by slow, heavier breathing. There are also moments where you stop breathing (apneas). Kussmaul breathing is rapid, deep breathing.

They’re both signs of potentially life-threatening conditions. Heart failure and stroke are the most common causes of Cheyne-Stokes respirations. Kussmaul breathing happens when your blood pH becomes too acidic.

What are the most common causes of Kussmaul breathing?

Kussmaul breathing happens when your blood becomes too acidic. To compensate, your body tries to get rid of carbon dioxide by breathing deeply and quickly.

Diabetes-related ketoacidosis (DKA) is the most common cause of Kussmaul breathing. DKA can happen in both Type 1 and Type 2 diabetes. But it’s more common in Type 1 diabetes, when you don’t have enough insulin to break down glucose (sugar) for energy. Your body uses fat instead, which releases ketones into your blood, making it acidic.

Renal tubular acidosis can also cause Kussmaul breathing. This is when your kidneys can’t get rid of acid properly, and it builds up in your blood. Autoimmune disease, inherited conditions and medications can cause it.

Other causes of Kussmaul breathing include:

• Alcohol use disorder
• Cancer
• Heart, kidney or liver failure
• Ingesting (eating or drinking) certain toxins
• Sepsis
• Severe malnutrition
• Severe dehydration

How is Kussmaul breathing treated?

Treatment for Kussmaul breathing depends on the cause. You’ll need to stay in a hospital. Treatment could include:

• IV fluids and electrolytes (like bicarbonate) to restore your blood’s pH balance
• Oxygen therapy to get more oxygen to your body
• IV insulin to manage blood glucose levels if you have DKA
• Diuretics to remove salt and water from your body if you have renal tubular acidosis

What are the possible complications or risks of not treating it?

Kussmaul breathing is a sign of a medical emergency. If severe acidosis isn’t treated right away, it can lead to organ failure and death.

Can you prevent Kussmaul breathing?

Managing diabetes or illnesses that can affect your kidneys can reduce your risk of acidosis, which may lead to Kussmaul breathing.

If you have diabetes, it’s important to:

• Check your blood sugar levels regularly, and take your insulin and any other medications as prescribed. This helps manage your blood sugar levels.
• Talk to your endocrinologist about how to manage diabetes when you’re sick. Being sick can put you at a higher risk for DKA.
• Know the early warning signs of DKA. Don’t wait to go to the emergency room if you have symptoms.

Early symptoms of DKA can include:

• Peeing more often than usual
• Extreme thirst
• Dehydration
• Headache
• High amounts of ketones in your pee or blood (as shown by at-home urine ketone test strips or a blood meter test)
• High blood sugar levels (over 250 mg/dL)

More severe symptoms of DKA can include:

• Nausea and vomiting
• Abdominal pain
• Fruity-smelling breath
• Feeling very tired or weak
• Confusion or altered mental state

When should this be treated by a healthcare provider?

Kussmaul breathing is usually a sign of a medical emergency. If you or someone you know is experiencing Kussmaul breathing, go to the nearest emergency room immediately.