Kussmaul breathing

Overview
Kussmaul breathing is the very deep and labored breathing with normal or reduced frequency, found among people with severe acidosis; it is a form of hyperventilation. Kussmaul breathing is named for Adolph Kussmaul, the 19th century German Physician who first noted it among patients with advanced diabetes (usually type I). He published his finding in a classic 1874 paper.

The cause of Kussmaul breathing is respiratory compensation for a metabolic acidosis, most commonly occurring in diabetics in diabetic ketoacidosis. Blood gases on a patient with Kussmaul breathing will show a low pCO2 because of a forced increased respiration (blowing off the carbon dioxide). The patient feels an urge to breathe deeply, an "air hunger", and it appears almost involuntary.

A metabolic acidosis soon produces hyperventilation, but at first it will tend to be rapid and relatively shallow. Kussmaul breathing develops as the acidosis grows more severe. Indeed, Kussmaul originally indentified this type of breathing as a sign of coma and imminent death in diabetic patients.

Duration of fasting, presence or absence of hepatomegaly and Kussmaul breathing provide clues to the differential diagnosis of hypoglycemia in the inborn errors of metabolism.