Kussmaul breathing describes a type of breathing that can indicate a disease. This disease is caused by acidosis, the overacidification of the body due to a disturbance in the acid-base balance.
What is Kussmaul breathing?
The symptoms of Kussmaul breathing are altered breathing similar to hyperventilation and metabolic acidosis. This acidosis can be identified by the characteristic odor of the sufferer’s breath.
Kussmaul breathing was named after the biologist and physician Adolf Kussmaul. It is also referred to as acidosis breathing and acidosis compensation breathing . This is a type of breathing called hyperventilation. Breathing is very deep and rapid to increase oxygen intake. See AbbreviationFinder for abbreviations related to Kussmaul Breathing.
This breathing is caused by metabolic acidosis. This leads to acidification of the blood in the patient’s body. The pH of the blood drops below 7.35 due to an accumulation of protons. The pH value is a measurement of the acidity caused by acids and bases in the body. Acids have a pH below 7 in aqueous solution and bases have a pH above 7. Human physiological pH is between 7.35 and 7.45.
Causes
The main cause of Kussmaul breathing is metabolic acidosis. The reasons for the occurrence of acidosis are manifold. Acidosis can result from diabetes mellitus that has not been properly controlled with medication, or from lactic acidosis, the buildup of lactic acid in the body.
Other causes include alcoholic ketoacidosis or prolonged starvation. Other causes of acidosis are methanol or salicylic poisoning. Acidosis can also be triggered by diarrhea, a condition that causes excessive emptying of the intestines.
In addition, renal insufficiency, the failure of the kidneys, which leads to an accumulation of so-called urinary substances in the blood, or Addison’s disease are causes of acidosis. Addison’s disease is a life-threatening condition that results in loss of adrenal gland function.
Symptoms, Ailments & Signs
The symptoms of Kussmaul breathing are altered breathing similar to hyperventilation and metabolic acidosis. This acidosis can be identified by the characteristic odor of the sufferer’s breath. With Kussmaul breathing, the body tries to remove carbon dioxide, which can be a source of acidosis, from the body by exhaling vigorously, normalizing the pH value in the blood and thus reducing acidosis.
In addition to breathing, an enlarged liver and high blood sugar, which also suggest diabetes mellitus, are indicators of an inherited metabolic disorder. This is an inherited disease that is divided into different categories depending on the type of metabolism or metabolism that is affected.
A distinction is made between carbohydrate, amino acid and steroid metabolism and the metabolism of lysosomal storage. Lysosomes are small membrane formations that contain enzymes that serve to break down parts of the cell that are no longer needed or no longer functional into their component parts so that they can be reused.
Diagnosis & course of disease
The Kussmaul respiration is based on a metabolic acidosis. This is determined using a blood gas analysis. This analysis determines the pH value and the concentration of oxygen and carbon dioxide in the blood. The pH of an adult should be between 7.35 and 7.45. The carbon dioxide partial pressure is normally 35 to 45 mm. So-called compensated hyperacidity can also occur.
Then the pH value is in the normal range, but the other values of the analysis indicate a disturbance. In addition, the pH value of the urine can also be determined in order to test the person concerned for possible acidosis. In the course of acidosis, there is a lack of oxygen. The organs are not supplied with enough oxygen. To compensate for the increased acidity, the body releases more water.
The increased acidification of the body can lead to tachycardia (palpitations). Other sequelae include impaired consciousness, a reduction in blood pressure, osteoporosis, rheumatoid arthritis, arteriosclerosis, and heart disease. Atherosclerosis is hardening of the arteries, which can lead to a heart attack. Rheumatoid arthritis is a disease of the joints that often becomes apparent with age.
Complications
In most cases, those affected by Kussmaul breathing suffer from severe hyperventilation. This causes breathing difficulties and those affected sometimes suffer from severe tiredness and exhaustion. It is also not uncommon for the patient to have reduced resilience. The liver is also often enlarged and causes pain.
Problems with the liver are generally dangerous and, in the worst case, can lead to the death of the person concerned. The patient’s metabolism is also restricted by Kussmaul breathing, resulting in digestive disorders and other complaints. The quality of life of the patient is significantly reduced by this disease. It is not uncommon for the symptoms to lead to mental illness or depression.
Furthermore, it is not uncommon for heart palpitations and disturbances of consciousness to occur. Patients may pass out or go into a coma. The treatment of Kussmaul breathing is carried out with the help of medication. Complications usually do not arise. However, the treatment of the underlying disease is also necessary to prevent further consequential damage.
When should you go to the doctor?
Anyone who notices a strong bad breath that cannot be remedied by strict oral hygiene should see their family or dentist. If there are accompanying signs of liver enlargement (e.g. liver pain or jaundice), a doctor must be consulted immediately. Severe tiredness, breathing difficulties and reduced resilience are further warning signs that require immediate clarification. In the event of cardiovascular problems or hyperventilation, the emergency doctor must be called or the patient must go to a clinic.
Patients suffering from diabetes, alcoholic ketoacidosis, chronic diarrhea or renal insufficiency are particularly prone to developing Kussmaul breathing. The symptoms also occur in the context of Addison’s disease and lactic acidosis. It is best for people who are part of these risk groups to go directly to the doctor’s office so that any complications can be clarified and comprehensively treated. During treatment, the patient must visit the doctor regularly. Since metabolic acidosis can recur again and again, further investigations are necessary even after treatment.
Treatment & Therapy
Metabolic acidosis is treated with different therapies depending on the cause. In diabetes mellitus, insulin is administered. If the breath is too acidic, the respiratory system is treated directly. This is done with bronchospasmolytics, a drug that causes the bronchi to widen.
The bronchial system of the lungs includes the airways that the inhaled or exhaled air takes in the lungs. To treat metabolic acidosis, buffering agents are administered to bring the pH back to normal. Tris buffer or sodium bicarbonate solutions are such buffer substances. If acidosis occurs due to kidney failure, it is treated with dialysis.
Outlook & Forecast
Kussmaul breathing is a specific type of breathing. This is caused by diabetes -related or metabolic acidosis in the body. The associated hyperventilation indicates a serious problem that requires immediate medical attention. Kussmaul breathing represents the attempt by the overly acidic or comatose organism to compensate for acidosis by exhaling extensive amounts of carbon dioxide.
If this very deep hyperventilation breathing is not correctly recognized for what it is, the sufferer faces a coma and then death. Those affected usually suffer from type 1 diabetes, very rarely from type 2 diabetes. A diabetic coma, which is accompanied by Kussmaul breathing, is an emergency situation. This requires immediate emergency medical treatment. Kussmaul breathing is often caused by severe hypoglycemia. However, ketoacidosis can also be present, which can be recognized by an acetone smell coming from the person’s mouth.
The emergency measures when Kussmaul breathing occurs must take into account that the person concerned may have administered too much insulin. Alternatively, he has not ingested enough food. The prognosis is good with immediate emergency measures. It is bad if help is not called immediately. This is the case, for example, when the patient lives alone and cannot perceive the condition that has gradually arisen.
Prevention
Metabolic acidosis and thus also Kussmaul breathing can be avoided if the underlying diseases that lead to acidification of the body are treated. Lung dysfunction, diabetes mellitus and renal insufficiency must be treated early to prevent acidosis.
In addition, a healthy diet and moderate consumption of alcohol are advisable to prevent the onset of acidosis and Kussmaul respiration. A sufficient amount of liquid, mainly water, also has a positive effect on the state of health.
Aftercare
In the case of Kussmaul breathing, follow-up care proves to be relatively difficult in most cases, and in many cases the affected person has no special follow-up care measures available. In the case of this disease, a doctor should therefore be consulted at an early stage so that no further symptoms arise. Complications can only be prevented by an early diagnosis, so that the affected person ideally seeks treatment as soon as the first signs of Kussmaul breathing appear.
As a rule, self-healing cannot occur. Most of those affected are dependent on taking different medicines. The doctor’s instructions should always be followed. When taking it, it is also important to ensure that the dosage is correct and that the medication is taken regularly.
Since diabetes also has to be treated for Kussmaul breathing, those affected should pay attention to their diet and, if necessary, follow a nutrition plan from a doctor. The further course of the disease depends heavily on the time of diagnosis, so that a general prediction cannot usually be given. However, in many cases Kussmaul breathing significantly reduces the life expectancy of those affected.
You can do that yourself
Patients who have been diagnosed with Kussmaul breathing should contact a specialist to clarify the causes. Depending on the underlying condition of metabolic acidosis, various measures can be taken to relieve the symptoms.
If diabetes mellitus is the cause, the patient must take insulin regularly. The most important measure is to ensure that the medication is well adjusted and to reduce the risk of hypoglycaemia. In addition, the lifestyle must be adjusted to reduce any excess weight and relieve the body as a whole. In a discussion with the specialist or a nutritionist, further measures can be developed to reduce the symptoms in the long term. If Kussmaul breathing is based on a disease of the respiratory system, drug treatment is indicated. Breathing exercises can help to widen the bronchi and reduce the symptoms in the long term.
If the metabolic acidosis is due to alcoholic ketoacidosis or prolonged fasting, the diet or lifestyle must be changed. Since these symptoms usually have a psychological cause, it makes sense to visit a therapist in addition to medical treatment.
