Kussmaul breathing is an abnormal breathing pattern characterized by rapid, deep breathing at a consistent pace. It’s a sign of a medical emergency — usually diabetes-related ketoacidosis (DKA), which can affect people with diabetes and people with undiagnosed Type 1 diabetes.
Kussmaul breathing (also called Kussmaul respirations) is an abnormal breathing pattern characterized by rapid, deep breathing at a consistent pace. It’s a form of hyperventilation.
Kussmaul breathing is a sign of metabolic acidosis (when there’s too much acid in your bloodstream) and most commonly results from diabetes-related ketoacidosis (DKA), a potentially life-threatening complication of diabetes.
Kussmaul breathing is occasionally described as “air hunger,” emphasizing the strong need to breathe and gasping for air. People who experience Kussmaul breathing have no control over the way they’re breathing. It’s their body’s response to an underlying condition.
This type of breathing is a sign of a medical emergency. Go to the nearest emergency room if you or someone you know is experiencing Kussmaul breathing.
Kussmaul respirations were originally observed and described by Dr. Adolf Kussmaul in 1874.
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Kussmaul breathing and Cheyne-Stokes respirations are both abnormal breathing patterns that are signs of potentially life-threatening conditions, but they’re different.
Cheyne-Stokes respirations can occur while you’re awake but usually occur during sleep. Cheyne-Stokes breathing involves a period of fast, shallow breathing followed by slow, heavier breathing and moments without any breath at all (apneas). The most common causes of Cheyne-Stokes respirations are heart failure and stroke.
Kussmaul breathing is rapid, deep breathing. It’s caused by metabolic acidosis, most commonly diabetes-related ketoacidosis (DKA).
Hyperventilation and Kussmaul breathing both result in lower carbon dioxide levels in your body, but with Kussmaul breathing, your body is purposefully trying to get rid of excess acid in your body in the form of carbon dioxide.
Hyperventilation alone typically isn’t dangerous, but Kussmaul breathing is a sign of a medical emergency.
Kussmaul breathing starts when acid levels in your body become too high, which is known as metabolic acidosis. Your body normally carefully controls the acidity level (pH) of your blood, which is usually in the range of 7.35 to 7.45. It’s considered acidic when it drops below 7.
When this drop happens, your body works to get rid of the extra acid by rapidly breathing out carbon dioxide, one of the main acids in your blood.
Kussmaul respirations can happen with any disorder that causes significant acidosis. The most common specific causes of Kussmaul breathing include:
Other causes of Kussmaul breathing include:
Treatment for Kussmaul breathing depends on the underlying cause. Regardless of the cause, you’ll likely need to stay in a hospital for treatment.
Healthcare providers usually treat metabolic acidosis with IV fluids and electrolytes to restore your blood’s pH balance.
In cases of diabetes-related ketoacidosis (DKA), the treatment also involves IV insulin. For renal tubular acidosis, your provider may prescribe diuretics to remove salt and water from your body.
Kussmaul breathing — and the conditions that cause it — can’t always be prevented.
For people who have been diagnosed with diabetes, diabetes-related ketoacidosis (DKA) — especially late-stage DKA — is usually (but not always) preventable.
If you have diabetes, it’s important to check your blood sugar levels regularly and take your insulin and any other medications as prescribed to prevent or treat high blood sugar (hyperglycemia). Talk to your endocrinologist about how to manage diabetes when you get sick. Being sick can put more stress on your body and put you at a higher risk of developing DKA.
For people who have undiagnosed Type 1 diabetes, DKA can be more difficult to prevent since they may not be aware of the warning signs of Type 1 diabetes and DKA. Kussmaul breathing typically happens in late-stage (severe) DKA.
Early symptoms of DKA can include:
More severe symptoms of DKA can include:
If you or your child is experiencing these symptoms, go to the nearest emergency room as soon as possible.
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.
A note from Cleveland Clinic
Kussmaul breathing is a serious sign of an underlying medical condition — most often diabetes-related ketoacidosis. If you or someone you know is experiencing rapid, deep breathing at a consistent pace, get to the nearest emergency room as soon as possible. Healthcare providers will treat it promptly and determine the underlying cause.
Last reviewed by a Cleveland Clinic medical professional on 01/06/2023.
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