Kussmaul breathing
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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 doctor who first noted it among patients with advanced diabetes (type I). He published his finding in a classic 1874 paper.[1]
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.
An urge for hyperventilation can be reproduced, to a degree, by rapidly breathing in the air in a recently-emptied plastic soft-drink bottle, which will normally contain a substantial amount of carbon dioxide. However, extending this experiment until a Kussmaul-like breathing results is inadvisable.
[edit] References
- ^ A. Kussmaul: Zur Lehre vom Diabetes mellitus. Über eine eigenthümliche Todesart bei Diabetischen, über Acetonämie, Glycerin-Behandlung des Diabetes und Einspritzungen von Diastase in’s Blut bei dieser Krankheit., Deutsches Archiv für klinische Medicin, Leipzig, 1874, 14: 1-46. English translation in Ralph Hermon Major (1884-1970), Classic Descriptions of Disease. Springfield, C. C. Thomas, 1932. 2nd edition, 1939, 3rd edition, 1945.
