Which metabolic state is commonly associated with Kussmaul respirations?

• A. Metabolic alkalosis
• B. Metabolic acidosis such as DKA
• C. Respiratory alkalosis
• D. Hypervolemia

Answer: (B)

Kussmaul respirations are a deep, labored breathing pattern that your body uses to compensate for metabolic acidosis by blowing off more carbon dioxide, which helps raise the blood’s pH. This pattern is most commonly seen with metabolic acidosis, such as in diabetic ketoacidosis (DKA) or lactic acidosis. The other states don’t produce this compensatory deep, heavy breathing: metabolic alkalosis tends to cause hypoventilation to retain CO2, respiratory alkalosis is driven by a primary loss of CO2 with hyperventilation, and hypervolemia is a fluid issue with no direct link to this breathing pattern. If you observe Kussmaul breathing, think metabolic acidosis and look for signs like dehydration, altered mental status, and possible hyperglycemia in the case of DKA.