What is Kussmaul Breathing?

Metabolic acidosis occurs when there is an excess of acid in the blood, and the body tries to restore balance by expelling it through respiration. Thus, it causes Kussmaul breathing.

woman panicked breathing

Normal breathing is approximately 12 to 20 times in a minute. An excess of the breaths per minute may indicate a medical condition that needs evaluation. One such example is deep and difficult breathing which is called Kussmaul breathing and could be an indication of a disorder with the kidneys. It is also usually linked with medical conditions related to metabolic disturbances like diabetes or kidney failure. So, what leads to this condition and how is it treated?

Why Does It Happen?

When acid levels in the body are too high, acidosis takes place. Thus, the body tries to restore balance by stimulating deep and long breaths to expel excessive amounts of acidic carbon dioxide. It also happens when the lungs or kidneys are failing.

Symptoms of Acidosis

Much like hyperventilation, Kussmaul breathing is described as panicked breathing. It occurs when there is too much acid in the blood. An individual will gasp for air, and it is often associated with a loud and powerful sound each time he inhales and exhales.

However, before Kussmaul breathing starts, an individual going through metabolic acidosis exhibits shallow and rapid breathing. Once the acidosis becomes severe, this is when deep and labored breathing kicks in. 

Severe acidosis is dangerous and may cause coma and organ failure. If left untreated, then it may lead to death.

Apart from Kussmaul breathing, here are the common signs of metabolic acidosis to look out for:

  • Drowsiness Without a Logical Reason
  • Extreme Exhaustion
  • Excessive Thirst
  • Feeling Nauseated or Sick
  • Fruity Breath
  • Headache
  • Increased Urination
  • Jaundice
  • Loss of Appetite
  • Mild Confusion
  • Rapid Heartbeat
  • Vomiting

If an individual manifests the symptoms mentioned above along with labored breathing, then he or she must get immediate medical aid.

What cause kussmaul breathing?


Diabetes is the common cause of this type of breathing. However, a condition that results in acidic blood may lead to Kussmaul breathing. Such cases include the following.

1. Drug-Induced Acidosis

Overconsumption of toxins or very acidic elements may overwork the body’s capacity to preserve its neutral pH. Such elements include poisons, strong alcohols like ethanol and methanol, antifreeze, acetylsalicylic acid, and acetazolamide.

2. Lactic Acidosis

When the tissues become starved from oxygen, lactic acid begins to accumulate in the blood. Factors that may cause lactic acidosis include the following.

  • Certain Cancers
  • Overexertion of Muscles
  • Overuse of Alcohol
  • Prolonged Elevated or Low Levels of Sugar in the Blood
  • Seizures

3. Ketoacidosis

When the body relies on fats for fuel rather than on carbohydrates, it leads to the release of ketones. These compounds accumulate in the blood and raise its acidity. Ketoacidosis is commonly associated with newly diagnosed or uncontrolled diabetes. Factors that may lead to ketoacidosis include poor nutrition, alcoholism, or starvation. An underproduction of insulin, an excess of glucagon in the body, diets high in fats, and obesity also heighten the risk of getting ketoacidosis.

4. Loss of Buffers or Bases

Chronic malnutrition, bowel disorders, diarrhea, or infection leads to the loss of chemical compounds That are vital in binding and managing hydrogen ions. Other conditions where there is a loss of buffers or bases include those mentioned below.

  • Sepsis: happens when there is excessive damage to the body’s healthy tissues as a result of the immune system’s release of chemicals to fight infections.
  • Unconsciousness: occurs when the body settles into a state of unconsciousness because of shock or acidosis. Deep and difficult breathing then sets in.
  • Kidney Disorders: This leads to the kidney’s impaired ability to extract hydrogen from the blood and release it via the urine.


Various tests are performed to confirm metabolic acidosis as well as its severity. These tests include the following.

  • Arterial Blood Gas Test
  • Blood Sugar Test
  • Electrolyte Test
  • General Metabolism Blood Panel Test
  • Urine Test

When an individual’s blood acid level is less than 7.35, then he or she is diagnosed with metabolic acidosis. An individual with diabetic ketoacidosis produces too many ketones and has an acidic pH.

Seek medical assistance when the blood sugar level is at 16.7 millimoles per liter or above 300 milligrams per deciliter.


If you are experiencing metabolic acidosis, you must bego to the hospital. There are a variety of treatment plans for the severity and type of acidosis. Initial treatment includes the intravenous or oral administration of fluids enhanced with electrolytes.

Even though Kussmaul breathing may look to be a problem with the respiratory system, the focus of treatment is on the cause of heavy breathing. Addressing Kussmaul breathing and ignoring its cause may cause severe damage to the body.

For individuals diagnosed with diabetic ketoacidosis, one inclusion in the treatment plan is the administration of insulin. On the other hand, individuals with kidney disorders are given sodium citrate or sodium bicarbonate orally to restore the normal levels of bicarbonate. Once the fluid and insulin levels in the body become balanced, the body then corrects the level of bicarbonate.

In individuals with lactic acidosis, treatment include administration of oxygen and insulin, intravenous fluids, and bicarbonate supplements. These will help return the pH levels in the body to a balanced state.

As for individuals with substance-based acidosis, the treatment requires the detoxification of the substances before electrolyte and fluid replacement therapies are administered.

The Difference from Cheyne Stokes

Kussmaul breathing is often mistaken for Cheyne Stokes since both are characterized by deep and labored breathing. Furthermore, for both types of abnormal breathing, it is also due to the excess of carbon dioxide. However, this is where the similarities end.

While Kussmaul breathing is characterized by rapid and deep breaths, Cheyne Stokes alternates between slow and fast breathing. It may also cause an individual to stop breathing or a period of apnea suddenly. Then the cycle repeats where there are a gradual increase and gradual decrease in respiration.

Cheyne Stokes is a frightening type of abnormal breathing and is also a serious condition that warrants swift medical attention.

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