10- Kussmaul breathing

KYJ10- Kussmaul Breathing.

Knowing your Jargon episode 10 looks at the characteristic breathing pattern called Kussmaul's.

Before we define it, let us review the primary stimulus to breathe.
Whilst at a superficial level breathing would appear to be about oxygen and CO2 levels, it's primary stimulus is CSF pH (potenz Hydrogen) or acidity of the cerebral spinal fluid. Blood pH influences CSF pH and the respiratory centre stimulates breathing rate and depth on this continual CSF sampling.

As waste CO2 increases, pH of blood drops (becomes acidic), this in turn drops CSF pH which stimulates the brain to drive your next breath.

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Now let's look at severe metabolic Acidosis (blood with low pH, low HCO3, & normal CO2) .
In this situation, the cause of acidosis could be many things, but commonly diabetic ketoacidosis, aspirin poisoning, cyanide exposure, alcoholic coma, inhalant abuse, lactic acidosis and acute renal failure.

In each of these examples, the pH is low, and the CO2 is usually normal .

So what does our brain do to respond to this dropping pH?  It stimulates the lungs to breathe deeper and faster... This characteristic rapid deep breathing (hyperventillation) is called Kussmaul breathing, is involuntary, and serves to "blow" or vent off as much CO2 as possible, in attempt to raise and correct pH.

Typically the patient takes deep and rapid breaths, and appears to be doing this with no effort.  It is completely autonomic/ involuntary.

Look for Kussmaul breathing in the next diabetic ketoacidosis patient you care for.

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