Kussmaul Breathing

Kussmaul breathing is a very dangerous symptom that accompanies conditions associated with disruption of internal environment and "acidification of the organism." Kussmaul breathing is described as a slightly faster breathing with deep strenuous breaths. It is a reflexive reaction of organism and it is usually present in unconscious patients.


Our body is accustomed to a stable internal environment and also to a certain pH (acidity) that is normally around 7.4. Higher pH means less acidity and on the contrary lower pH means more acidic environment. Under certain circumstances an increase or decrease of pH may occur. Our body tries to maintain stable pH by using so-called buffer systems. These buffer systems consist of chemical substances that are able to take up or release hydrogen ions (H+) that are responsible for acidity.


Carbonate ion CO3- is an important compound of these buffer systems. It can scavenge hydrogen ions to form very weak carbonic acid H2CO3 that easily disintegrates into water (H2O) and carbon dioxide (CO2). Carbon dioxide create by this reaction accumulates in body and Kussmaul breathing serves to breath it out.


As mentioned above, Kussmaul breathing associates with metabolic acidosis. Metabolic acidosis is condition when pH decreases due to some metabolic disturbance in the body. Two most common medical situations typical with metabolic acidosis are:

Diabetic ketocacidosis

This situation is typical for untreated type 1 diabetes. Disruption of glucose metabolism and formation of acidic ketone bodies causes a pH decrease.

Lactic acidosis

This includes the entire group of conditions that are associated with a decrease of blood pH and increased concentration of lactic acid in the blood. For more information, please refer to relevant text. Let’s just mention that it is usually a result of serious conditions accompanied with insufficient tissue oxygenation or it can be a side effect of certain medications.


Kussmaul breathing is not a disease, it is only a symptom. Due to current disruption of internal environment of the body and usual unconsciousness, Kussmaul breathing diagnosis must be regarded as serious. Therapy consists in treating the underlying cause.

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources